§ 74. 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,¹ 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 (cripple the body internally or externally), in order to preserve the organism from complete destruction of life by the ever-renewed, hostile assaults of such destructive forces.²

§ 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 Homœopathy, 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,³ 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 over-exertion 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. 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.⁴

§ 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, whilst 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 odor), 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,⁵ 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 hæmatodes, neoplasms, gout, hæmorrhoids, jaundice, cyanosis, dropsy, amenorrhœa, hæmorrhage 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.

§ 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 circumstances⁶ 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,⁷ under a number of special names, as diseases of an independent character.

§ 82. Although, by the discovery of that great source of chronic diseases, as also by the discovery of the specific homœopathic 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 homœopathic 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,⁸ 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.

§ 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 them⁹ 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.

§ 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? Whilst 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,¹⁰ 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.

§ 88. If in these voluntary details nothing has been mentioned respecting several facts or functions of the body or his mental state, the physician asks what more can he told in regard to these parts and these functions, or the state of his disposition or mind ;¹¹ 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.

§ 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 informaton he needs) to ask more precise, more special questions.¹²

§ 90. When the physician has finished writing down these particulars, he then makes a note of what he himself observes in the patient,¹³ and ascertains how much of that was peculiar to the patient in his healthy state.

§ 91. The symptoms and feelings of the patient during a previous course of medicine do not furnish the pure picture of the disease; but, on the other hand, those symptoms and ailments which he suffered from before the use of the medicines, or after they had been discontinued for several days, give the true fundamental idea of the original form of the disease, and these especially the physician must take note of. When the disease is of a chronic character, and the patient has been taking medicine up to the time he is seen, the physician may with advantage leave him some days quite without medicine, or in the meantime administer something of an unmedicinal nature and defer to a subsequent period the more precise scrutiny of the morbid symptoms, in order to be able to grasp in their purity the permanent uncontaminated symptoms of the old affection and to form a faithful picture of the disease.

§ 92. But if it be a disease of a rapid course, and if its serious character admit of no delay, the physician must content himself with observing the morbid condition, altered though it may be by medicines, if he cannot ascertain what symptoms were present before the employment of the medicines,—in order that he may at least form a just apprehension of the complete picture of the disease in its actual condition, that is to say, of the conjoint malady formed by the medicinal and original diseases, which from the use of inappropriate drugs is generally more serious and dangerous than was the original disease, and hence demands prompt and efficient aid; and by thus tracing out the complete picture of the disease he will be enabled to combat it with a suitable homœopathic remedy, so that the patient shall not fall a sacrifice to the injurious drugs he has swallowed.

Notas

The only possible case of plethora shows itself with the healthy woman, several days before her monthly period, with a feeling of a certain fulness of womb and breasts, but without inflammation. ↩
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 medicinally helpful, where as 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 homœopathic 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 intented by the Creator for bloodmaking 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 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. ↩
If the patient at length succumbs, the practiser of such a treatment is in the habit of pointing out to the sorrowing relatives, at the post-mortem examination, these internal organic disfigurements, which are due to his pseudo-art, but which he artfully maintains to be the original incurable disease (see my book, Die Allöopathie, ein Wort der Warnung an Kranke jeder Art, Leipzig, bei Baumgartner [translated in Lesser Writings]). Those deceitful records, the illustrated works on pathological anatomy, exhibit the products of such lamentable bungling. Deceased people from the country and those from the poor of cities who have died without such bungling with hurtful measures are not opened up through pathological anatomy as a rule. Such corruption and deformities would not be found in their corpses. From this fact can be judged the value of the evidence drawn from these beautiful illustrations as well as of the honesty of these authors and book makers. ↩
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 unrecognized for years. Those afflicted appear 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. ↩
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., Düsseldorf, Schaub.]) before I had obtained this knowledge I could only teach how to 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 homœopathic 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 (homœopathic) 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. ↩
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. ↩
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, leucorrhœa, hæmorrhoids, rheumatism, apoplexy, convulsions, hysteria, hypochrondriasis, 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 quædam nomina morbis imponere iisque aptare velle generalem quandam 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 Fritze 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, gaol 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 a 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 universæ qua patet medicinæ pomœria perlustrantem, tanta admiratione percellet, quam discolor illa et sui plane dissimilis morborum Epidemicorum facies; non tam qua varias ejusdem anni tempestates, quam qua discrepantes diversorum ab invicem annorum constitutiones referunt, ab iisque dependent. Quæ tam aperta prædictorum 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, et symptomatis aliquot utrisque pariter supervenientibus, convenire paulo incautioribus videantur, re tamen ipsa (si bene adverteris animum,) alienæ admodum esse indolis, et distare ut æra 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 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 diseases of these and similar names of fixed unvarying character. ↩
Hence the following directions for investigating the symptoms are only partially applicable for acute diseases. ↩
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. ↩
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. ↩
For example, what is 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 humor, 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? ↩
For example, how often are his bowels moved? What is the exact character of the stools? Did the whitish evacuation consist of mucus or fæces? 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 color when first emitted? Of what color 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 does he feel immediately after waking from sleep? 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 rigor 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 subsequently 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?

In women, note the character of menstruation and other discharges, etc. ↩
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 color 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 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. ↩