§ 61–90

§ 61

Had physicians been capable of reflecting on the sad results of the antagonistic employment of medicines, they had long since discovered the grand truth, THAT THE TRUE RADICAL HEALING ART MUST BE FOUND IN THE EXACT OPPOSITE OF SUCH AN ANTIPATHIC TREATMENT OF THE SYMPTOMS OF DISEASE; they would have become convinced, that as a medicinal action antagonistic to the symptoms of the disease (an antipathically employed medicine) is followed by only transient relief, and after that is passed, by invariable aggravation, the converse of that procedure, the homoeopathic employment of medicines according to similarity of symptoms, must effect a permanent and perfect cure, if at the same time the opposite of their large doses, the most minute doses, are exhibited. But neither the obvious aggravation that ensued from their antipathic treatment, nor the fact that no physician ever effected a permanent cure of disease of considerable or of long standing unless some homoeopathic medicinal agent was accidentally a chief ingredient in his prescription, nor yet the circumstances that all the rapid and perfect cures that nature ever performed (§ 46), were always effected by the supervention upon the old disease of one of a similar character, ever taught them, during such a long series of centuries, this truth, the knowledge of which can alone conduce to the benefit of the sick.

§ 62

But on what this pernicious result of the palliative, antipathic treatment and the efficacy of the reverse, the homoeopathic treatment, depend, is explained by the following facts, deduced from manifold observations, which no one before me perceived, though they are so very palpable and so very evident, and are of such infinite importance to the healing art.

§ 63

Every agent that acts upon the vitality, every medicine, deranges more or less the vital force, and causes a certain alteration in the health of the individual for a longer or a shorter period. This is termed primary action. Although a product of the medicinal and vital powers conjointly, it is principally due to the former power. To its action our vital force endeavours to oppose its own energy. This resistant action is a property, is indeed an automatic action of our life-preserving power, which goes by the name of secondary action or counteraction.

§ 64

During the primary action of the artificial morbific agents (medicines) on our healthy body, as seen in the following examples, our vital force seems to conduct itself merely in a passive (receptive) manners, and appears, so to say, compelled to permit the impressions of the artificial power acting from without to take place in it and thereby alter its state of health; it then, however, appears to rouse itself again, as it were, and to develop (A) the exact opposite condition of health (counteraction, secondary action) to this effect (primary action) produced upon it, if there be such an opposite, and that in as great a degree as was the effect (primary action) of the artificial morbific agent on it, and proportionate to its own energy; – or (B) if there be not in nature a state exactly the opposite of the primary action, it appears to endeavour to indifferentiate itself, that is, to make its superior power available in the extinction of the change wrought in it from without (by the medicine), in the place of which it substitutes its normal state (secondary action, curative action).

§ 65

Examples of (A) are familiar to all. A hand bathed in hot water is at first much warmer than the other hand that has not been so treated (primary action); but when it is withdrawn from the hot water and again thoroughly dried, it becomes in a short time cold, and at length much colder than the other (secondary action). A person heated by violent exercise (primary action) is afterwards affected with chilliness and shivering (secondary action). To one who was yesterday heated by drinking much wine (primary action), today every breath of air feels too cold (counteraction of the organism, secondary action). An arm that has been kept long in very cold water is at first much paler and colder (primary action) than the other; but removed from the cold water and dried, it subsequently becomes not only warmer than the other, but even hot, red and inflamed (secondary action, reaction of the vital force). Excessive vivacity follows the use of strong coffee (primary action), but sluggishness and drowsiness remain for a long time afterwards (reaction, secondary action), if this be not always again removed for a short time by imbibing fresh supplies of coffee (palliative). After the profound stupefied sleep caused by opium (primary action), the following night will be all the more sleepless (reaction, secondary action). After the constipation produced by opium (primary action), diarrhoea ensues (secondary action); and after purgation with medicines that irritate the bowels, constipation of several days' duration ensues (secondary action). And in like manner it always happens, after the primary action of a medicine that produces in large doses a great change in the health of a healthy person, that its exact opposite, when, as has been observed, there is actually such a thing, is produced in the secondary action by our vital force.

§ 66

An obvious antagonistic secondary action, however, is, as may readily be conceived, not to be noticed from the action of quite minute homoeopathic doses of the deranging agents on the healthy body. A small dose of every one of them certainly produces a primary action that is perceptible to a sufficiently attentive observer; but the living organism employs against it only so much reaction (secondary action) as is necessary for the restoration of the normal condition.

§ 67

These incontrovertible truths, which spontaneously offer themselves to our notice and experience, explain to us the beneficial action that takes place under homoeopathic treatment; while, on the other hand, they demonstrate the perversity of the antipathic and palliative treatment of diseases with antagonistically acting medicines.[74] [75] [76]

[74] Only in the most urgent cases, where danger to life and imminent death allow no time for the action of a homoeopathic remedy – not hours, sometimes not even quarter-hours, and scarcely minutes – in sudden accidents occurring to previously healthy individuals – for example, in asphyxia and suspended animation from lightning, from suffocation, freezing, drowning, etc. – is it admissible and judicious, at all events as a preliminary measure to stimulate the irritability and sensibility (the physical life) with a palliative, as for instance, with gentle electrical shocks, with clysters of strong coffee, with a stimulating odour, gradual application of heat, etc. When this stimulation is effected, the play of the vital organs again goes on in its former healthy manner, for there is here no disease* to be removed, but merely an obstruction and suppression of the healthy vital force. To this category belong various antidotes to sudden poisoning: alkalis from mineral acids, hepar sulphuris for metallic poisons, coffee and camphora (and ipecacuanha) for poisoning by opium, etc. It does not follow that a homoeopathic medicine has been ill selected for a case of disease because some of the medicinal symptoms are only antipathic to some of the less important and minor symptoms of the disease; if only the others, the stronger well-marked (characteristic), and peculiar symptoms of the disease are covered and matched by the same medicine with similarity of symptoms – that is to say, overpowered, destroyed and extinguished; the few opposite symptoms also disappear of themselves after the expiry of the term of action of the medicament, without retarding the cure in the least.

[75] 5th Edition footnote to the previous footnote following the word “disease”: * And yet the new sect that mixes the two systems appeals (though in vain) to this observation, in order that they may have an excuse for encountering everywhere such exceptions to the general rule in diseases, and to justify their convenient employment of allopathic palliatives, and of other injurious allopathic trash besides, solely for the sake of sparing themselves the trouble of seeking for the suitable homoeopathic remedy for each case of disease – I might almost say for the sake of sparing themselves the trouble of being homoeopathic physicians, and yet wishing to appear as such. But their performances are on a par with the system they pursue; they are nothing to boast of.

[76] 6th Edition footnote to the previous footnote following the word “disease”: * And yet the new sect that mixes the two systems appeals (though in vain) to this observation, in order that they may have an excuse for encountering everywhere such exceptions to the general rule in diseases, and to justify their convenient employment of allopathic palliatives, and of other injurious allopathic trash besides, solely for the sake of sparing themselves the trouble of seeking for the suitable homoeopathic remedy for each case of disease – and thus conveniently appear as homoeopathic physicians, without being such. But their performances are on a par with the system they pursue; they are corrupting.

§ 68 6th edition

In homoeopathic cures they show us that from the uncommonly small doses of medicine (§ 275 - § 287) required in this method of treatment, which are just sufficient, by the similarity of their symptoms, to overpower and remove from the sensation of the life principle the similar natural disease there certainly remains, after the destruction of the latter, at first a certain amount of medicinal disease alone in the organism, but, on account of the extraordinary minuteness of the dose, it is so transient, so slight, and disappears so rapidly of its own accord, that the vital force has no need to employ, against this small artificial derangement of its health, any more considerable reaction than will suffice to elevate its present state of health up to the healthy point – that is, than will suffice to effect complete recovery, for which after the extinction of the previous morbid derangement but little effort is required (§ 64, B).

§ 69 6th edition

In the antipathic (palliative) mode of treatment, however precisely the reverse of this takes place. The medicinal symptom which the physician opposes to the disease symptom (for example, the insensibility and stupefaction caused by opium in its primary action to acute pain) is certainly not alien, not allopathic of the latter; there is a manifest relation of the medicinal symptom to the disease symptom, but it is the reverse of what should be; it is here intended that the annihilation of the disease symptom shall be effected by an opposite medicinal symptom, which is nevertheless impossible. No doubt the antipathically chosen medicine touches precisely the same diseased point in the organism as the homoeopathic medicine chosen on account of the similar affection it produces; but the former covers the opposite symptom of the disease only as an opposite, and makes it unobservable to our life principle for a short time only, so that in the first period of the action of the antagonistic palliative the vital force perceives nothing disagreeable from either if the two (neither from the disease symptom nor from the medicinal symptom), as they seem both to have mutually removed and dynamically neutralized one another as it were (for example, the stupefying power of opium does this to the pain). In the first minutes the vital force feels quite well, and perceives neither the stupefaction of the opium nor the pain of the disease. But as the antagonistic medicinal symptom cannot (as in the homoeopathic treatment) occupy the place of the morbid derangement present in the organism in the sensation of the life principle as a similar, stronger (artificial) disease, and cannot, therefore, like a homoeopathic medicine, affect the vital force with a similar artificial disease, so as to be able to step into the place of the original natural morbid derangement, the palliative medicine must, as a thing totally differing from, and the opposite of the disease derangement, leave the latter uneradicated; it renders it, as before said, by a semblance of dynamic neutralization[77], at first unfelt by the vital force, but, like every medicinal disease, it is soon spontaneously extinguished, and not only leaves the disease behind, just as it was, but compels the vital force (as it must, like all palliatives, be given in large doses in order to effect the apparent removal) to produce an opposite condition (§ 63 - 65) to this palliative medicine, the reverse of the medicinal action, consequently the analogue of the still present, undestroyed, natural morbid derangement, which is necessarily strengthened and increased[78] by this addition (reaction against the palliative) produced by the vital force. The disease symptom (this single part of the disease) consequently becomes worse after the term of the action of the palliative has expired; worse in proportion to the magnitude of the dose of the palliative. Accordingly (to keep to the same example) the larger the dose of opium given to allay the pain, so much the more does the pain increase beyond its original intensity as soon as the opium has exhausted its action.[79]

§ 70 6th edition

From what has been already adduced we cannot fail to draw the following inferences:

That everything of a really morbid character and which ought to be cured that the physician can discover in diseases consists solely of the sufferings of the patient, and the sensible alterations in his health, in a word, solely of the totality of the symptoms, by means of which the disease demands the medicine requisite for its relief; while, on the other hand, every internal cause attributed to it, every occult quality or imaginary material morbific principle, is nothing but an idle dream;

That this derangement of the state of health, which we term disease, can only be converted into health by another revolution effected in the state of health by means of medicines, whose sole curative power, consequently, can only consist in altering man's state of health – that is to say, in a peculiar excitation of morbid symptoms, and is learned with most distinctness and purity by testing them on the healthy body;

That, according to all experience, a natural disease can never be cured by medicines that possess the power of producing in the healthy individual an alien morbid state (dissimilar morbid symptoms) differing from that of the disease to be cured (never, therefore, by an allopathic mode of treatment), and that even in nature no cure ever takes place in which an inherent disease is removed, annihilated and cured by the addition of another disease dissimilar to it, be the new one ever so strong;

That, moreover, all experience proves that, by means of medicines which have a tendency to produce in the healthy individual an artificial morbid symptom, antagonistic to the single symptom of disease sought to be cured, the cure of a long-standing affection will never be effected, but merely a very transient alleviation, always follows by its aggravation; and that, in a word, this antipathic and merely palliative treatment in long-standing diseases of a serious character is absolutely inefficacious;

That, however, the third and only other possible mode of treatment (the homoeopathic), in which there is employed for the totality of the symptoms of a natural disease a medicine capable of producing the most similar symptoms possible in the healthy individual, given in suitable dose, is the only efficacious remedial method whereby diseases, which are purely dynamic deranging irritations of the vital force, are overpowered, and being thus easily, perfectly and permanently extinguished, must necessarily cease to exist. This is brought about by means of the stronger similar deranging irritation of the homoeopathic medicine in the sensation of the life principle. – and for this mode of procedure we have the example of unfettered Nature herself, when to an old disease there is added a new one similar to the first, whereby the new one is rapidly and forever annihilated and cured.

§ 71

As it is now no longer a matter of doubt that the diseases of mankind consist merely of groups of certain symptoms, and may be annihilated and transformed into health by medicinal substances, but only by such as are capable of artificially producing similar morbid symptoms (and such is the process in all genuine cures), hence the operation of curing is comprised in the three following points:

I. How is the physician to ascertain what is necessary to be known in order to cure the disease?

II. How is he to gain a knowledge of the instruments adapted for the cure of the natural disease, the pathogenetic powers of the medicines?

III. What is the most suitable method of employing these artificial morbific agents (medicines) for the cure of natural disease?

§ 72

With respect to the first point, the following will serve as a general preliminary view. The disease to which man is liable are either rapid morbid processes of the abnormally deranged vital force, which have a tendency to finish their course more or less quickly, but always in a moderate time - - these are termed acute diseases; – or they are diseases of such a character that, with small, often imperceptible beginnings, dynamically derange the living organism, each in its own peculiar manner, and cause it gradually to deviate from the healthy condition, in such a way that the automatic life energy, called vital force, whose office is to preserve the health, only opposes to them at the commencement and during their progress imperfect, unsuitable, useless resistance, but is unable of itself to extinguish them, but must helplessly suffer (them to spread and) itself to be ever more and more abnormally deranged, until at length the organism is destroyed; these are termed chronic diseases. They are caused by infection with a chronic miasm.

§ 73

As regards acute diseases, they are either of such a kind as attack human beings individually, the exciting cause being injurious influences to which they were particularly exposed. Excesses in food, or an insufficient supply of it, severe physical impression, chills, over heatings, dissipation, strains, etc., or physical irritations, mental emotions, and the like, are exciting causes of such acute febrile affections; in reality, however, they are generally only a transient explosion of latent psora, which spontaneously returns to its dormant state if the acute diseases were not of too violent a character and were soon quelled. Or they are of such a kind as attack several persons at the same time, here and there (sporadically), by means of meteoric or telluric influences and injurious agents, the susceptibility for being morbidly affected by which is possessed by only a few persons at one time. Allied to these are those diseases in which many persons are attacked with very similar sufferings from the same cause (epidemically); these diseases generally become infectious (contagious) when they prevail among thickly congregated masses of human beings. Thence arise fevers[80], in each instance of a peculiar nature, and, because the cases of disease have an identical origin, they set up in all those they affect an identical morbid process, which when left to itself terminates in a moderate period of time in death or recovery. The calamities of war, inundations and famine are not infrequently their exciting causes and producers – sometimes they are peculiar acute miasms which recur in the same manner (hence known by some traditional name), which either attack persons but once in a lifetime, as the smallpox, measles, whooping-cough, the ancient, smooth, bright red scarlet fever[81] of Sydenham, the mumps, etc., or such as recur frequently in pretty much the same manner, the plague of the Levant, the yellow fever of the sea-coast, the Asiatic cholera, etc.

[80] The homoeopathic physician, who does not entertain the foregone conclusion devised by the ordinary school (who have fixed upon a few names of such fevers, besides which mighty nature dare not produce any others, so as to admit of their treating these disease according to some fixed method), does not acknowledge the names goal fever, bilious fever, typhus fever, putrid fever, nervous fever or mucous fever, but treats them each according to their several peculiarities.

[81] Subsequently to the year 1801 a kind of purpura miliaris (roodvonk), which came from the West, was by physicians confounded with the scarlet fever, notwithstanding that they exhibited totally different symptoms, that the latter found its prophylatic and curative remedy in belladonna, the former in aconite, and that the former was generally merely sporadic, while the latter was invariable epidemic. Of late years it seems as if the two occasionally joined to form an eruptive fever of a peculiar kind, for which neither the one nor the other remedy, alone, will be found to be exactly homoeopathic.

§ 74 6th edition

Among chronic diseases we must still, alas!, reckon those so commonly met with, artificially produced in allopathic treatment by the prolonged use of violent heroic medicines in large and increasing doses, by the abuse of calomel, corrosive sublimate, mercurial ointment, nitrate of silver, iodine and its ointments, opium, valerian, cinchona bark and quinine, foxglove, prussic acid, sulphur and sulphuric acid, perennial purgatives, venesections, shedding streams of blood, leeches, issues, setons, etc., whereby the vital energy is sometimes weakened to an unmerciful extent, sometimes, if it do not succumb, gradually abnormally deranged (by each substance in a peculiar manner) in such a way that, in order to maintain life against these inimical and destructive attacks, it must produce a revolution in the organism, and either deprive some part of its irritability and sensibility, or exalt these to an excessive degree, cause dilatation or contraction, relaxation or induration or even total destruction of certain parts, and develop faulty organic alterations here and there in the interior or the exterior[82] (cripple the body internally or externally), in order to preserve the organism from complete destruction of the life by the ever-renewed, hostile assaults of such destructive forces.[83]

[83] Among all imaginable methods for the relief of sickness, no greater allopathic, irrational or inappropriate one can be thought of than this Brousseauic, debilitating treatment by means of venesection and hunger diet, which for many years has spread over a large part of the earth. No intelligent man can see in it anything medical, or medically helpful, whereas real medicines, even if chosen blindly and administered to a patient, may at times prove of benefit in a given case of sickness because they may accidentally have been homoeopathic to the case. But from venesection, healthy common sense can expect nothing more than certain lessening and shortening of life. It is a sorrowful and wholly groundless fallacy that most and indeed all diseases depend on local inflammation. Even for true local inflammation, the most certain and quickest cure is found in medicines capable of taking away dynamically the arterial irritation upon which the inflammation is based and this without the least loss of fluids and strength. Local venesections, even from the affected part, only tend to increase renewed inflammation of these parts. And precisely so it is generally inappropriate, aye, murderous to take away many pounds of blood from the veins in inflammatory fevers, when a few appropriate medicines would dispel this irritated arterial state, driving the hitherto quiet blood together with the disease in a few hours without the least loss of fluids and strength. Such great loss of blood is evidently irreplaceable for the remaining continuance of life, since the organs intended by the Creator for blood-making have thereby become so weakened that while they may manufacture blood in the same quantity but not again of the same good quality. And how impossible is it for this imagined plethora to have been produced in such remarkable rapidity and so to drain it off by frequent venesections when yet an hour before the pulse of this heated patient (before the fever and chill stage) was so quiet. No man, no sick person has ever too much blood (the only possible case of plethora shows itself with the healthy woman, several days before her monthly period, with a feeling of a certain fullness of womb and breasts, but without inflammation) or too much strength. On the contrary, every sick man lacks strength, otherwise his vital energy would have prevented the development of the disease. Thus it is irrational and cruel to add to this weakened patient, a greater, indeed the most serious source of debility that can be imagined. It is a murderous malpractice irrational and cruel based on a wholly groundless and absurd theory instead of taking away his disease which is ever dynamic and only to be removed by dynamic potencies.

§ 75

These inroads on human health effected by the allopathic non-healing art (more particularly in recent times) are of all chronic diseases the most deplorable, the most incurable; and I regret to add that it is apparently impossible to discover or to hit upon any remedies for their cure when they have reached any considerable height.

§ 76

Only for natural diseases has the beneficent Deity granted us, in Homoeopathy, the means of affording relief; but those devastations and maimings of the human organism exteriorly and interiorly, effected by years, frequently, of the unsparing exercise of a false art, with its hurtful drugs and treatment, must be remedied by the vital force itself (appropriate aid being given for the eradication of any chronic miasm that may happen to be lurking in the background), if it has not already been too much weakened by such mischievous acts, and can devote several years to this huge operation undisturbed. A human healing art, for the restoration to the normal state of those innumerable abnormal conditions so often produced by the allopathic non-healing art, there is not and cannot be.

§ 77

Those diseases are inappropriately named chronic, which persons incur who expose themselves continually to avoidable noxious influences, who are in the habit of indulging in injurious liquors or aliments, are addicted to dissipation of many kinds which undermine the health, who undergo prolonged abstinence from things that are necessary for the support of life, who reside in unhealthy localities, especially marshy districts, who are housed in cellars or other confined dwellings, who are deprived of exercise or of open air, who ruin their health by overexertion of body or mind, who live in a constant state of worry, etc. These states of ill-health, which persons bring upon themselves, disappear spontaneously, provided no chronic miasm lurks in the body, under an improved mode of living, and they cannot be called chronic diseases.

§ 78 6th edition

The true natural chronic diseases are those that arise from a chronic miasm, which when left to themselves, and unchecked by the employment of those remedies that are specific for them, always go on increasing and growing worse, notwithstanding the best mental and corporeal regimen, and torment the patient to the end of his life with ever aggravated sufferings. These, excepting those produced by medical malpractice (§ 74), are the most numerous and greatest scourges of the human race; for the most robust constitution, the best regulated mode of living and the most vigorous energy of the vital force are insufficient for their eradication.[84]

[84] During the flourishing years of youth and with the commencement of regular menstruation joined to a mode of life beneficial to soul, heart and body, they remain unrecognised for years. Those afflicted appeal in perfect health to their relatives and acquaintances and the disease that was received by infection or inheritance seems to have wholly disappeared. But in later years, after adverse events and conditions of life, they are sure to appear anew and develop the more rapidly and assume a more serious character in proportion as the vital principle has become disturbed by debilitating passions, worry and care, but especially when disordered by inappropriate medicinal treatment.

§ 79

Hitherto syphilis alone has been to some extent known as such a chronic miasmatic disease, which when uncured ceases only with the termination of life. Sycosis (the condylomatous disease), equally ineradicable by the vital force without proper medicinal treatment, was not recognized as a chronic miasmatic disease of a peculiar character, which it nevertheless undoubtedly is, and physicians imagined they had cured it when they had destroyed the growths upon the skin, but the persisting dyscrasia occasioned by it escaped their observation.

§ 80

Incalculably greater and more important than the two chronic miasms just named, however, is the chronic miasm of psora, which, while those two reveal their specific internal dyscrasia, the one by the venereal chancre, the other by the cauliflower-like growths, does also, after the completion of the internal infection of the whole organism, announce by a peculiar cutaneous eruption, sometimes consisting only of a few vesicles accompanied by intolerable voluptuous tickling itching (and a peculiar odour), the monstrous internal chronic miasm – the psora, the only real fundamental cause and producer of all the other numerous, I may say innumerable, forms of disease[85], which, under the names of nervous debility, hysteria, hypochondriasis, mania, melancholia, imbecility, madness, epilepsy and convulsions of all sorts, softening of the bones (rachitis), scoliosis and cyphosis, caries, cancer, fungus nematodes, neoplasms, gout, haemorrhoids, jaundice, cyanosis, dropsy, amenorrhoea, haemorrhage from the stomach, nose, lungs, bladder and womb, of asthma and ulceration of the lungs, of impotence and barrenness, of megrim, deafness, cataract, amaurosis, urinary calculus, paralysis, defects of the senses and pains of thousands of kinds, etc., figure in systematic works on pathology as peculiar, independent diseases.

[85] I spent twelve years in investigating the source of this incredibly large number of chronic affections, in ascertaining and collecting certain proofs of this great truth, which had remained unknown to all former or contemporary observers, and in discovering at the same time the principal (antipsoric) remedies, which collectively are nearly a match for this thousand-headed monster of disease in all its different developments and forms. I have published my observations on this subject in the book entitled The Chronic Diseases (4 vols., Dresden, Arnold. [2nd edit., Dusseldorf, Schaub.]) before I had obtained this knowledge I could only treat the whole number of chronic diseases as isolated, individual maladies, with those medicinal substances whose pure effects had been tested on healthy persons up to that period, so that every case of chronic disease was treated by my disciples according to the group of symptoms it presented, just like an idiopathic disease, and it was often so far cured that sick mankind rejoiced at the extensive remedial treasures already amassed by the new healing art. How much greater cause is there now for rejoicing that the desired goal has been so much more nearly attained, inasmuch as the recently discovered and far more specific homoeopathic remedies for chronic affections arising from psora (properly termed antipsoric remedies) and the special instructions for their preparation and employment have been published; and from among them the true physician can now select for his curative agents those whose medicinal symptoms correspond in the most similar (homoeopathic) manner to the chronic disease he has to cure; and thus, by the employment of (antipsoric) medicines more suitable for this miasm, he is enabled to render more essential service and almost invariably to effect a perfect cure.

§ 81

The fact that this extremely ancient infecting agent has gradually passed, in some hundreds of generations, through many millions of human organisms and has thus attained an incredible development, renders it in some measure conceivable how it can now display such innumerable morbid forms in the great family of mankind, particularly when we consider what a number of circumstances[86] contribute to the production of these great varieties of chronic diseases (secondary symptoms of psora), besides the indescribable diversity of men in respect of their congenital corporeal constitutions, so that it is no wonder if such a variety of injurious agencies, acting from within and from without and sometimes continually, on such a variety of organisms permeated with the psoric miasm, should produce an innumerable variety of defects, injuries, derangements and sufferings, which have hitherto been treated of in the old pathological works[87], under a number of special names, as diseases of an independent character.

[86] Some of these causes that exercise a modifying influence on the transformation of psora into chronic diseases manifestly depend sometimes on the climate and the peculiar physical character of the place of abode, sometimes on the very great varieties in the physical and mental training of youth, both of which may have been neglected, delayed or carried to excess, or on their abuse in the business or conditions of life, in the matter of diet and regimen, passions, manners, habits and customs of various kinds.

[87] How many improper ambiguous names do not these works contain, under each of which are included excessively different morbid conditions, which often resemble each other in one single symptom only, as ague, jaundice, dropsy, consumption, leucorrhoea, haemorrhoids, rheumatism, apoplexy, convulsions, hysteria, hypochondriasis, melancholia, mania, quinsy, palsy, etc., which are represented as diseases of a fixed and unvarying character, and are treated, on account of their name, according to a determinate plan! How can the bestowal of such a name justify an identical medical treatment? And if the treatment is not always to be the same, why make use of an identical name which postulates an identity of treatment? “Nihil sane in artem medicam pestiferum magis unquam irrepsit malum, quam generalia quaedam medicinam,” says Huxham, a man as clear-sighted as he was estimable on account of his conscientiousness (Op. phys. med., tom. I.). And in like manner Frittze laments (Annalen, I, p.80) “that essentially different diseases are designated by the same name.” Even those epidemic diseases, which undoubtedly may be propagated in every separate epidemic by a peculiar contagious principle which remains unknown to us, are designated, in the old school of medicine by particular names, just as if they were well-known fixed diseases that invariably recurred under the same form, as hospital fever, goal fever, camp fever, putrid fever, bilious fever, nervous fever, mucous fever, although each epidemic of such roving fevers exhibits itself at every occurrence as another, a new disease, such as it has never before appeared in exactly the same form, differing very much, in every instance, in its course, as well as in many of its most striking symptoms and its whole appearance. Each is so far dissimilar to all previous epidemics, whatever names they may bear, that it would be dereliction of all logical accuracy in our ideas of things were we to give to these maladies, that differ so much among themselves, one of those names we meet with in pathological writings, and treat them all medicinally in conformity with this misused name. The candid Sydenham alone perceived this, when he (Obs. med., cap. ii, De morb, epid.) insists upon the necessity of not considering any epidemic disease as having occurred before and treating it in the same way as another, since all that occur successively, be they ever so numerous, differ from one another: “Nihil quicquam (opinor) animum universae qua patet medicinae pomoeria perlustrantem, tanta admiratione percellet, quam discolor illa et sui plane dissimilis morborum Epidemicorum facies; non tam qua varias ejusdem anni tempestates, quam qua discrepantes divewrsorum ab invicem annorum constitutiones referunt, ab iisque dependent. Quae tam aperta praedictorum morborum diversitas tum propriis ac sibi peculiaribus symptomatis, tum etiam medendi ratione, quam hi ab illis disparem prorsus sibi vendicant, satis illucescit. Ex quibus constat morbus hosce, ut ut externa quadantenus specie, er symptomatis aliquot utrisque pariter super venientibus, convenire paulo incautioribus videantur, re tamen ipsa (si bene adverteris animum), alienae admondum esse indolis, et distare ut aera lupinis.”From all this it is clear that these useless and misused names of diseases ought to have no influence on the practice of the true physician, who knows that he has to judge of and to cure diseases, not according to the similarity of the name of a single one of their symptoms, but according to the totality of the signs of the individual state of each particular patient, whose affection it is his duty carefully to investigate, but never to give a hypothetical guess at it. If, however, it is deemed necessary sometimes to make use of names of diseases, in order, when talking about a patient to ordinary persons, to render ourselves intelligible in few words, we ought only to employ them as collective names, and tell them, e.g., the patient has a kind of St. Vitus's dance, a kind of dropsy, a kind of typhus, a kind of ague; but (in order to do away once and for all with the mistaken notions these names give rise to) we should never say he has the St. Vitus's dance, the typhus, the dropsy, the ague, as there are certainly no disease of these and similar names of fixed unvarying character.

§ 82

Although, by the discovery of that great source of chronic diseases, as also by the discovery of the specific homoeopathic remedies for the psora, medicine has advanced some steps nearer to a knowledge of the nature of the majority of diseases it has to cure, yet, for settling the indication in each case of chronic (psoric) disease he is called on to cure, the duty of a careful apprehension of its ascertainable symptoms and characteristics is as indispensable for the homoeopathic physician as it was before that discovery, as no real cure of this or of other diseases can take place without a strict particular treatment (individualization) of each case of disease – only that in this investigation some difference is to be made when the affection is an acute and rapidly developed disease, and when it is a chronic one; seeing that, in acute disease, the chief symptoms strike us and become evident to the senses more quickly, and hence much less time is requisite for tracing the picture of the disease and much fewer questions are required to be asked[88], as almost everything is self-evident, than in a chronic disease which has been gradually progressing for several years, in which the symptoms are much more difficult to be ascertained.

[88] Hence the following directions for investigating the symptoms are only partially applicable for acute diseases.

§ 83

This individualizing examination of a case of disease, for which I shall only give in this place general directions, of which the practitioner will bear in mind only what is applicable for each individual case, demands of the physician nothing but freedom from prejudice and sound senses, attention in observing and fidelity in tracing the picture of the disease.

§ 84

The patient details the history of his sufferings; those about him tell what they heard him complain of, how he has behaved and what they have noticed in him; the physician sees, hears, and remarks by his other senses what there is of an altered or unusual character about him. He writes down accurately all that the patient and his friends have told him in the very expressions used by them. Keeping silence himself he allows them to say all they have to say, and refrains from interrupting them[89] unless they wander off to other matters. The physician advises them at the beginning of the examination to speak slowly, in order that he may take down in writing the important parts of what the speakers say.

[89] Every interruption breaks the train of thought of the narrators, and all they would have said at first does not again occur to them in precisely the same manner after that.

§ 85

He begins a fresh line with every new circumstance mentioned by the patient or his friends, so that the symptoms shall be all ranged separately one below the other. He can thus add to any one, that may at first have been related in too vague a manner, but subsequently more explicitly explained.

§ 86

When the narrators have finished what they would say of their own accord, the physician then reverts to each particular symptom and elicits more precise information respecting it in the following manner; he reads over the symptoms as they were related to him one by one, and about each of them he inquires for further particulars, e.g., at what period did this symptom occur? Was it previous to taking the medicine he had hitherto been using? While taking the medicine? Or only some days after leaving off the medicine? What kind of pain, what sensation exactly, was it that occurred on this spot? Where was the precise spot? Did the pain occur in fits and by itself, at various times? Or was it continued, without intermission? How long did it last? At what time of the day or night, and in what position of the body was it worst, or ceased entirely? What was the exact nature of this or that event or circumstance mentioned – described in plain words?

§ 87

And thus the physician obtains more precise information respecting each particular detail, but without ever framing his questions so as to suggest the answer to the patient[90], so that he shall only have to answer yes or no; else he will be misled to answer in the affirmative or negative something untrue, half true, or not strictly correct, either from indolence or in order to please his interrogator, from which a false picture of the disease and an unsuitable mode of treatment must result.

[90] For instance the physician should not ask, “Was not this or that circumstance present?” He should never be guilty of making such suggestions, which tend to seduce the patient into giving a false answer and a false account of his symptoms.

§ 88

If in these voluntary details nothing has been mentioned respecting several parts or functions of the body or his metal state, the physician asks what more can be told in regard to these parts and these functions, or the state of his disposition or mind[91], but in doing this he only makes use of general expressions, in order that his informants may be obliged to enter into special details concerning them.

[91] For example what was the character of his stools? How does he pass his water? How is it with his day and night sleep? What is the state of his disposition, his humour, his memory? How about the thirst? What sort of taste has he in his mouth? What kinds of food and drink are most relished? What are most repugnant to him? Has each its full natural taste, or some other unusual taste? How does he feel after eating or drinking? Has he anything to tell about the head, the limbs or the abdomen?

§ 89

When the patient (for it is on him we have chiefly to rely for a description of his sensations, except in the case of feigned diseases) has by these details, given of his own accord and in answer to inquiries, furnished the requisite information and traced a tolerably perfect picture of the disease, the physician is at liberty and obliged (if he feels he has not yet gained all the information he needs) to ask more precise, more special questions.[92]

[92] For example, how often are his bowels moved? What is the exact character of the stools? Did the whitish evacuation consist of mucus or faeces? Had he or had he not pains during the evacuation? What was their exact character, and where were they seated? What did the patient vomit? Is the bad taste in the mouth putrid, or bitter, or sour, or what? before or after eating, or during the repast? At what period of the day was it worst? What is the taste of what is eructated? Does the urine only become turbid on standing, or is it turbid when first discharged? What is its colour when first emitted? Of what colour is the sediment? How does he behave during sleep? Does he whine, moan, talk or cry out in his sleep? Does he start during sleep? Does he snore during inspiration, or during expiration? Does he lie only on his back, or on which side? Does he cover himself well up, or can he not bear the clothes on him? Does he easily awake, or does he sleep too soundly? How often does this or that symptom occur? What is the cause that produces it each time it occurs? does it come on whilst sitting, lying, standing, or when in motion? only when fasting, or in the morning, or only in the evening, or only after a meal, or when does it usually appear? When did the rigour come on? was it merely a chilly sensation, or was he actually cold at the same time? if so, in what parts? or while feeling chilly, was he actually warm to the touch? was it merely a sensation of cold, without shivering? was he hot without redness of the face? what parts of him were hot to the touch? or did he complain of heat without being hot to the touch? How long did the chilliness last? how long the hot stage? When did the thirst come on – during the cold stage? during the heat? or previous to it? or subsequent to it? How great was the thirst, and what was the beverage desired? When did the sweat come on – at the beginning or the end of the heat? or how many hours after the heat? when asleep or when awake? How great was the sweat? was it warm or cold? on what parts? how did it smell? What does he complain of before or during the cold stage? what during the hot stage? what after it? what during or after the sweating stage? [6th Ed. only] In women, note the character of menstruation and other discharges, etc.

§ 90

When the physician has finished writing down these particulars, he then makes a note of what he himself observes in the patient[93], and ascertains how much of that was peculiar to the patient in his healthy state.

[93] For example, how the patient behaved during the visit – whether he was morose, quarrelsome, hasty, lachrymose, anxious, despairing or sad, or hopeful, calm etc. Whether he was in a drowsy state or in any way dull of comprehension; whether he spoke hoarsely, or in a low tone, or incoherently, or how otherwise did he talk? what was the colour of his face and eyes, and of his skin generally? what degree of liveliness and power was there in his expression and eyes? what was the state of his tongue, his breathing, the smell from his mouth, and his hearing? were his pupils dilated or contracted? how rapidly and to what extent did they alter in the dark and in the light? what was the character of the pulse? what was the condition of the abdomen? how moist or hot, how cold or dry to the touch, was the skin of this or that part or generally? whether he lay with head thrown back, with mouth half or wholly open, with the arms placed above the head, on his back, or in what other position? what effort did he make to raise himself? and anything else in him that may strike the physician as being remarkable.