§ 201. It is evident that man’s vital force, when encumbered with a chronic disease which it is unable to overcome by its own powers instinctively, adopts the plan of developing a local malady on some external part, solely for this object, that by making and keeping in a diseased state this part which is not indispensable to human life, it may thereby silence the internal disease, which otherwise threatens to destroy the vital organs (and to deprive the patient of life), and that it may thereby, so to speak, transfer the internal disease to the vicarious local affection and, as it were, draw it thither. The presence of the local affection thus silences, for a time, the internal disease, though without being able either to cure it or to diminish it materially.¹ The local affection, however, is never anything else than a part of the general disease, but a part of it increased all in one direction by the organic vital force, and transferred to a less dangerous (external) part of the body, in order to allay the internal ailment. But (as has been said) by this local symptom that silences the internal disease, so far from anything being gained by the vital force towards diminishing or curing the whole malady, the internal disease, on the contrary, continues, in spite of it, gradually to increase and Nature is constrained to enlarge and aggravate the local symptom always more and more, in order that it may still suffice as a substitute for the increased internal disease and may still keep it under. Old ulcers on the legs get worse as long as the internal psora is uncured, the chancre enlarges as long as the internal syphilis remains uncured, the fig warts increase and grow while the sycosis is not cured whereby the latter is rendered more and more difficult to cure, just as the general internal disease continues to increase as time goes on.

§ 202. If the old-school physician should now destroy the local symptom by the topical application of external remedies, under the belief that he thereby cures the whole disease, Nature makes up for its loss by rousing the internal malady and the other symptoms that previously existed in a latent state side by side with the local affection; that is to say, she increases the internal disease. When this occurs it is usual to say, though incorrectly, that the local affection has been driven back into the system or upon the nerves by the external remedies.

§ 203. Every external treatment of such local symptoms, the object of which is to remove them from the surface of the body, whilst the internal miasmatic disease is left uncured, as, for instance, driving off the skin the psoric eruption by all sorts of ointments, burning away the chancre by caustics and destroying the condylomata on their seat by the knife, the ligature or the actual cautery; this pernicious external mode of treatment, hitherto so universally practised, has been the most prolific source of all the innumerable named or unnamed chronic maladies under which mankind groans; it is one of the most criminal procedures the medical world can be guilty of, and yet it has hitherto been the one generally adopted, and taught from the professional chairs as the only one.²

§ 204. If we deduct all chronic affections, ailments and diseases that depend on a persistent unhealthy mode of living (§ 77), as also those innumerable medicinal maladies (v. § 74) caused by the irrational, persistent, harassing and pernicious treatment of diseases often only of trivial character by physicians of the old school, most the remainder of chronic diseases result from the development of these three chronic miasms, internal syphilis, internal sycosis, but chiefly and in infinitely greater proportion, internal psora. Each of these infections was already in possession of the whole organism, and had penetrated it in all directions before the appearance of the primary, vicarious local symptom of each of them (in the case of psora the scabious eruption, in syphilis the chancre or the bubo, and in sycosis the condylomata) that prevented their outburst; and these chronic miasmatic diseases, if deprived of their local symptom, are inevitably destined by mighty Nature sooner or later to become developed and to burst forth, and thereby propagate all the nameless misery, the incredible number of chronic diseases which have plagued mankind for hundreds and thousands of years, none of which would so frequently have come into existence had physicians striven in a rational manner to cure radically and to extinguish in the organism these three miasms without employing local remedies for their corresponding external symptoms, relying solely on the proper internal homœopathic remedies for each. (See note to § 282.)

§ 205. The homœopathic physician never treats one of these primary symptoms of chronic miasms, nor yet one of their secondary affections that result from their further development, by local remedies (neither by those external agents that act dynamically,³ nor yet by those that act mechanically), but he cures, in cases where the one or the other appears, only the great miasm on which they depend, whereupon its primary, as also its secondary symptoms disappear spontaneously; but as this was not the mode pursued by the old-school practitioners who preceded him in the treatment of the case, the homœopathic physician generally, alas! finds that the primary symptoms⁴ have already been destroyed by them by means of external remedies, and that he has now to do more with the secondary ones, i. e., the affections resulting from the breaking forth and development of these inherent miasms, but especially with the chronic diseases evolved from internal psora, the internal treatment of which, as far as a single physician can elucidate it by many years of reflection, observation and experience, I have endeavored to point out in my work on Chronic Diseases, to which I must refer the reader.

§ 206. Before commencing the treatment of a chronic disease, it is necessary to make the most careful investigation⁵ as to whether the patient has had a venereal infection (or an infection with condylomatous gonorrhœa); for then the treatment must be directed towards this alone, when only the signs of syphilis (or of the rarer condylomatous disease) are present, but this disease is very seldom met with alone nowadays. If such infection have previously occurred, this must also be borne in mind in the treatment of those cases in which psora is present, because in them the latter is complicated with the former, as is always the case when the symptoms are not those of pure syphilis; for when the physician thinks he has a case of old venereal disease before him, he has always, or almost always, to treat a syphilitic affection accompanied mostly by (complicated with) psora for the internal itch dyscrasia (the psora) is far the most frequent fundamental cause of chronic diseases. At times, both miasms may be complicated also with sycosis in chronically diseased organisms, or, as is much more frequently the case, psora is the sole fundamental cause of all other chronic maladies, whatever names they may bear, which are, moreover, so often bungled, increased and disfigured to a monstrous extent by allopathic unskilfulness.

§ 207. When the above information has been gained, it still remains for the homœopathic physician to ascertain what kinds of allopathic treatment had up to that date been adopted for the chronic disease, what perturbing medicines had been chiefly and most frequently employed, also what mineral baths had been used and what effects these had produced, in order to understand in some measure the degeneration of the disease from its original state, and, where possible, to correct in part these pernicious artificial operations, or to enable him to avoid the employment of medicines that have already been improperly used.

§ 208. The age of the patient, his mode of living and diet, his occupation, his domestic position, his social relations and so forth must next be taken into consideration, in order to ascertain whether these things have tended to increase his malady, or in how far they may favor or hinder the treatment. In like manner the state of his disposition and mind must be attended to, to learn whether that presents any obstacle to the treatment, or requires to be directed, encouraged or modified.

§ 209. After this is done, the physician should endeavor in repeated conversations with the patient to trace the picture of his disease as completely as possible, according to the directions given above, in order to be able to elucidate the most striking and peculiar (characteristic) symptoms, in accordance with which he selects the first antipsoric or other remedy having the greatest symptomatic resemblance, for the commencement of the treatment, and so forth.

§ 210. Of psoric origin are almost all those diseases that I have above termed one-sided, which appear to be more difficult to cure in consequence of this one-sidedness, all their other morbid symptoms disappearing, as it were, before the single, great, prominent symptom. Of this character are what are termed mental diseases. They do not, however, constitute a class of disease sharply separated from all others, since in all other so-called corporeal diseases the condition of the disposition and mind is always altered;⁶ and in all cases of disease we are called on to cure the state of the patient’s disposition is to be particularly noted, along with the totality of the symptoms, if we would trace an accurate picture of the disease, in order to be able therefrom to treat it homœopathically with success.

§ 211. This holds good to such an extent, that the state of the disposition of the patient often chiefly determines the selection of the homœopathic 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, homœopathically—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.⁷

§ 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, whilst 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 homœopathic 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 psychical symptom, and became a disease of the mind and disposition. This may be learned from the report of the patient’s friends.

§ 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 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 homœopathic 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 psychical disease have already lasted some time.

§ 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 antipsorics, but in the first place with remedies indicated for it out of the other class of proved medicaments (e. g., aconite, belladonna, stramonium, hyoscyamus, mercury, etc.) in highly potentized, minute, homœopathic 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,⁸ 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.

§ 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.⁹

§ 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 homœopathic antipsoric medicine conjoined with carefully regulated mode of life, an appropriate psychical behavior 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 endeavor 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 tortures¹⁰ 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 homœopathic 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.

§ 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 cure; it is only when the bodily health is changed for the better that tranquillity and comfort again beam upon their mind.¹¹

§ 230. If the antipsoric remedies selected for each particular case of mental or emotional disease (there are incredibly numerous varieties of them) be quite homœopathically 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 homœopathic 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 homœopathic 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.

Σημειώσεις

The issues of the old-school practitioners do something similar; as artificial ulcers on external parts, they silence some internal chronic diseases, but only for a very short time, as long as they cause a painful irritation to which the sick organism is not used, without being able to cure them; but, on the other hand, they weaken and destroy the general health much more than is done by most of the metastases effected by the instinctive vital force. ↩
For any medicines that might at the same time be given internally served but to aggravate the malady, as these remedies possessed no specific power of curing the whole disease, but assailed the organism, weakened it and inflicted on it, in addition, other chronic medicinal diseases. ↩
I cannot therefore advise, for instance, the local extirpation of the so-called cancer of the lips and face (the product of highly developed psora, not infrequently in conjunction with syphilis) by means of the arsenical remedy of Frère Cosme, not only because it is excessively painful and often fails, but more for this reason, because, if this dynamic remedy should indeed succeed in freeing the affected part of the body from the malignant ulcer locally, the basic malady is thereby not diminished in the slightest, the preserving vital force is therefore necessitated to transfer the field of operation of the great internal malady to some more important part (as it does in every case of metastasis), and the consequence is blindness, deafness, insanity, suffocative asthma, dropsy, apoplexy, etc. But this ambiguous local liberation of the part from the malignant ulcer by the topical arsenical remedy only succeeds, after all, in those cases where the ulcer has not yet attained any great size, and when the vital force is still very energetic; but it is just in such a state of things that the complete internal cure of the whole original disease is also till practicable.

The result is the same without previous cure of the inner miasm when cancer of the face or breast is removed by the knife alone and when encysted tumors are enucleated; something worse ensues, or at any rate death is hastened. This has been the case times without number, but the old school still goes blindly on in the same way in every new case, with the same disastrous results. ↩
Itch eruption, chancre (bubo), condylomata. ↩
In investigations of this nature we must not allow ourselves to be deceived by the assertions of the patients or their friends, who frequently assign as the cause of chronic, even of the severest and most inveterate diseases, either a cold caught (a thorough wetting, drinking cold water after being heated) many years ago, or a former fright, a sprain, a vexation (sometimes even a bewitchment), etc. These causes are much too insignificant to develop a chronic disease in a healthy body, to keep it up for years, and to aggravate it year by year, as is the case with all chronic diseases from developed psora. Causes of a much more important character than these remembered noxious influences must lie at the root of the initiation and progress of a serious, obstinate disease of long standing; the assigned causes could only rouse into activity the latent chronic miasm. ↩
How often, for instance, do we not meet with a mild, soft disposition in patients who have for years been afflicted with the most painful diseases, so that the physician feels constrained to esteem and compassionate the sufferer! But if he subdue the disease and restore the patient to health—as is frequently done in homœopathic practice—he is often astonished and horrified at the frightful alteration in his disposition. He often witnesses the occurrence of ingratitude, cruelty, refined malice and propensities most disgraceful and degrading to humanity, which were precisely the qualities possessed by the patient before he grew ill.

Those who were patient when well often become obstinate, violent, hasty, or even intolerate and capricious, or impatient or desponding when ill; those formerly chaste and modest often become lascivious and shameless. A clear-headed person not infrequently becomes obtuse of intellect, while one ordinarily weak-minded becomes more prudent and thoughtful; and a man slow to make up his mind sometimes acquires great presence of mind and quickness of resolve, etc. ↩
Thus aconite will seldom or never effect either 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 ↩
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 ridicuously honored by allopathic ostentation with the title of rational medicine. How often, on the other hand, has not the true healing art, genuine, pure homœopathy, been able to restore such unfortunate beings to the possession of their mental and corporeal health, and to give them back again to their delighted friends and to the world! ↩
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 if 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. ↩
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 diseases, which is by homœopathic 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 chastisements 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. ↩
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. ↩