Samuel Hahnemann

Organon of Medicine 6th Edition

151

But if the patient complain of a few violent sufferings, the physician will usually find, on investigation, several other symptoms besides, although of a slighter character, which furnish a complete picture of the disease.

152

The worse of the acute disease is, of so much the more numerous and striking symptoms is it generally composed, but with so much the more certainly may a suitable remedy for it be found, if there be a sufficient number of medicines known, with respect to their positive action, to choose from. Among the lists of symptoms of many medicines it will not be difficult to find one from whose separate disease elements an antitype of curative artificial disease, very like the totality of the symptoms of the natural disease, may be constructed, and such a medicine is the desired remedy.

153^{Fifth Edition}

In this search for a homoeopathic specific remedy, that is to say, in this comparison of the collective symptoms of the natural disease with the list of symptoms of known medicines, in order to find among these an artificial morbific agent corresponding by similarity to the disease to be cured, the more striking, singular, uncommon and peculiar (characteristic) signs and symptoms¹ of the case of disease are chiefly and most solely to be kept in view; for it is more particularly these that very similar ones in the list of symptoms of the selected medicine must correspond to, in order to constitute it the most suitable for effecting the cure. The more general and undefined symptoms: loss of appetite, headache, debility, restless sleep, discomfort, and so forth, demand but little attention when of that vague and indefinite character, if they cannot be more accurately described, as symptoms of such a general nature are observed in almost every disease and from almost every drug.

1) Dr. von Bonninghausen, who has already distinguished himself by his labours in connection with the new system of medicine, has lately increased our obligation to him by the publication of his important little book setting forth the characteristic symptoms, more particularly of the antipsoric medicines, entitled Uebersicht der Hauptwirkungs-Sphure der antips. Arz., Munster, bei Coppenrath, 1883, and the appendix thereto (containing the antisyphilitic and the antisycotic medicines) at the end of the second edition of his Systematisch-alphabetisches Repertorium der antipsorischen Arzneien, bei Coppenrath in Munster.

153^{Sixth Edition}

In this search for a homoeopathic specific remedy, that is to say, in this comparison of the collective symptoms of the natural disease with the list of symptoms of known medicines, in order to find among these an artificial morbific agent corresponding by similarity to the disease to be cured, the more striking, singular, uncommon and peculiar (characteristic) signs and symptoms¹ of the case of disease are chiefly and most solely to be kept in view; for it is more particularly these that very similar ones in the list of symptoms of the selected medicine must correspond to, in order to constitute it the most suitable for effecting the cure. The more general and undefined symptoms: loss of appetite, headache, debility, restless sleep, discomfort, and so forth, demand but little attention when of that vague and indefinite character, if they cannot be more accurately described, as symptoms of such a general nature are observed in almost every disease and from almost every drug.

1) Dr. von Bonninghausen, by the publication of the characteristic symptoms of homoeopathic medicines and his repertory has rendered a great service to homoeopathy as well as Dr. J.H.G. Jahr in his handbook of principal symptoms.

154

If the antitype constructed from the list of symptoms of the most suitable medicine contain those peculiar, uncommon, singular and distinguishing (characteristic) symptoms, which are to be met with in the disease to be cured in the greatest number and in the greatest similarity, this medicine is the most appropriate homoeopathic specific remedy for this morbid state; the disease, if it be not one of very long standing, will generally be removed and extinguished by the first dose of it, without any considerable disturbance.

155^{Fifth Edition}

I say without any considerable disturbance. For in the employment of this most appropriate homoeopathic remedy it is only the symptoms of the medicine that correspond to the symptoms of the disease that are called into play, the former occupying the place of the latter (weaker) in the organism, and thereby annihilating them by overpowering them; but the other symptoms of the homoeopathic medicine, which are often very numerous, being in no way applicable to the case of disease in question, are not called into play at all. The patient, growing hourly better, feels almost nothing of them at all, because the excessively minute dose requisite for homoeopathic use is much too weak to produce the other symptoms of the medicine that are not homoeopathic to the case, in those parts of the body that are free from disease, and consequently can allow only the homoeopathic symptoms to act on the parts of the organism that are already most irritated and excited by the similar symptoms of the disease, thus changing the morbid affection of the vital force into a similar but stronger medicinal disease, whereby the original malady is extinguished.

155^{Sixth Edition}

I say without any considerable disturbance. For in the employment of this most appropriate homoeopathic remedy it is only the symptoms of the medicine that correspond to the symptoms of the disease that are called into play, the former occupying the place of the latter (weaker) in the organism, i.e., in the sensation of the life principle, and thereby annihilating them by overpowering them; but the other symptoms of the homoeopathic medicine, which are often very numerous, being in no way applicable to the case of disease in question, are not called into play at all. The patient, growing hourly better, feels almost nothing of them at all, because the excessively minute dose requisite for homoeopathic use is much too weak to produce the other symptoms of the medicine that are not homoeopathic to the case, in those parts of the body that are free from disease, and consequently can allow only the homoeopathic symptoms to act on the parts of the organism that are already most irritated and excited by the similar symptoms of the disease, in order that the sick life principle may react only to a similar but stronger medicinal disease, whereby the original malady is extinguished.

156

There is, however, almost no homoeopathic medicine, be it ever so suitably chosen, that, especially if it should be given in an insufficiently minute dose, will not produce, in very irritable and sensitive patients, at least one trifling, unusual disturbance, some slight new symptom while its action lasts; for it is next to impossible that medicine and disease should cover one another symptomatically as exactly as two triangles with equal sides and equal angles. But this (in ordinary circumstances) unimportant difference will be easily done away with by the potential activity (energy) of the living organism, and is not perceptible by patients not excessively delicate; the restoration goes forward, notwithstanding, to the goal of perfect recovery, if it be not prevented by the action of heterogeneous medicinal influences upon the patient, by errors of regimen or by excitement of the passions.

157^{Fifth Edition}

But though it is certain that a homoeopathically selected remedy does, by reason of its appropriateness and the minuteness of the dose, gently remove and annihilate the acute disease analogous to it, without manifesting its other unhomoeopathic symptoms, that is to say, without the production of new, serious disturbances, yet it usually, immediately after ingestion - for the first hour, or for a few hours - causes a kind of slight aggravation (where the dose has been somewhat too large, however, for a considerable number of hours), which has so much resemblance to the original disease that it seems to the patient to be an aggravation of his own disease. But it is, in reality, nothing more than an extremely similar medicinal disease, somewhat exceeding in strength the original affection.

157^{Sixth Edition}

But though it is certain that a homoeopathically selected remedy does, by reason of its appropriateness and the minuteness of the dose, gently remove and annihilate the acute disease analogous to it, without manifesting its other unhomoeopathic symptoms, that is to say, without the production of new, serious disturbances, yet it usually, immediately after ingestion - for the first hour, or for a few hours - causes a kind of slight aggravation when the dose has not been sufficiently small and (where the dose has been somewhat too large, however, for a considerable number of hours), which has so much resemblance to the original disease that it seems to the patient to be an aggravation of his own disease. But it is, in reality, nothing more than an extremely similar medicinal disease, somewhat exceeding in strength the original affection.

158

This slight homoeopathic aggravation during the first hours - a very good prognostic that the acute disease will most probably yield to the first dose - is quite as it ought to be, as the medicinal disease must naturally be somewhat stronger than the malady to be cured if it is to overpower and extinguish the latter, just as a natural disease can remove and annihilate another one similar to it only when it is stronger than the latter (§§ 43 - 48).

159^{Fifth Edition}

The smaller the dose of the homoeopathic remedy is, so much the slighter and shorter is the apparent increase of the disease during the first hours.

159^{Sixth Edition}

The smaller the dose of the homoeopathic remedy is in the treatment of acute diseases so much the slighter and shorter is the apparent increase of the disease during the first hours.

160

But as the dose of a homoeopathic remedy can scarcely ever be made so small that it shall not be able to relieve, overpower, indeed completely cure and annihilate the uncomplicated natural disease of not long standing that is analogous to it (§ 249, note), we can understand why a does of an appropriate homoeopathic medicine, not the very smallest possible, does always, during the first hour after its ingestion, produce a perceptible homoeopathic aggravation of this kind.¹

1) This exaltation of the medicinal symptoms over those disease symptoms analogous to them, which looks like an aggravation, has been observed by other physicians also, when by accident they employed a homoeopathic remedy. When a patient suffering from itch complains of an increase of the eruption after sulphur, his physician who knows not the cause of this, consoles him with the assurance that the itch must first come out properly before it can be cured; he knows not, however, that this is a sulphur eruption, that assumes the appearance of an increase of the itch.
"The facial eruption which the viola tricolor cured was aggravated by it at the commencement of its action," Leroy tells us (Heilk, fur Mutter, p.406), but he knew not that the apparent aggravation was owing to the somewhat too large dose of the remedy, which in this instance was to a certain extent homoeopathic. Lysons says (Med. Transact., vol ii, London, 1772), "The bark of the elm cures most certainly those skin diseases which it increases at the beginning of its action." Had he not given the bark in the monstrous doses usual in the allopathic system, but in the quite small doses requisite when the medicine shows similarity of symptoms, that is to say, when it is used homoeopathically, he would have effected a cure without, or almost without, seeing this apparent increase of the disease (homoeopathic aggravation).

161^{Fifth Edition}

When I here limit the so-called homoeopathic aggravation, or rather the primary action of the homoeopathic medicine that seems to increase somewhat the symptoms of the original disease, to the first or few hours, this is certainly true with respect to diseases of a more acute character and of recent origin, but where medicines of long action have to combat a malady of, considerable or of very long standing, where one dose, consequently, must continue to act for many days, we then occasionally see, during the first six, eight or ten days, the occurrence of some such primary actions, of the medicine, some such apparent increase of the symptoms of the original disease (lasting for one or several hours), while in the intervening hours amelioration of the whole malady is perceptible. After the lapse of these few days the amelioration resulting from such primary action of the medicine proceeds almost uninterruptedly for several days longer.

161^{Sixth Edition}

When I here limit the so-called homoeopathic aggravation, or rather the primary action of the homoeopathic medicine that seems to increase somewhat the symptoms of the original disease, to the first or few hours, this is certainly true with respect to diseases of a more acute character and of recent origin, but where medicines of long action have to combat a malady of, considerable or of very long standing, where no such apparent increase of the original disease ought to appear during treatment and it does not so appear if the accurately chosen medicine was given in proper small, gradually higher doses, each somewhat modified with renewed dynamization (§ 247). Such increase of the original symptoms of a chronic disease can appear only at the end of treatment when the cure is almost or quite finished.

162

Sometimes happens, owing to the moderate number of medicines yet known with respect to their true, pure action , that but a portion of the symptoms of the disease under treatment are to be met with in the list of symptoms of the most appropriate medicine, consequently this imperfect medicinal morbific agent must be employed for lack of a more perfect one.

163

In this case we cannot indeed expect from this medicine a complete, untroubled cure; for during its use some symptoms appear which were not previously observable in the disease, accessory symptoms of the not perfectly appropriate remedy. This does by no means prevent a considerable part of the disease (the symptoms of the disease that resemble those of the medicine) from being eradicated by this medicine, thereby establishing a fair commencement of the cure, but still this does not take place without those accessory symptoms, which are, however, always moderate when the dose of the medicine is sufficiently minute.

164

The small number of homoeopathic symptoms present in the best selected medicine is no obstacle to the cure in cases where these few medicinal symptoms are chiefly of an uncommon kind and such as are peculiarly distinctive (characteristic) of the disease; the cure takes place under such circumstances without any particular disturbance.

165

If, however, among the symptoms of the remedy selected, there be none that accurately resemble the distinctive (characteristic), peculiar, uncommon symptoms of the case of disease, and if the remedy correspond to the disease only in the general, vaguely described, indefinite states (nausea, debility, headache, and so forth), and if there be among the known medicines none more homoeopathically appropriate, in that case the physician cannot promise himself any immediate favorable result from the employment of this unhomoeopathic medicine.

166

Such a case is, however, very rare, owing to the increased number of medicines whose pure effects are now known, and the bad effects resulting from it, when they do occur, are diminished whenever a subsequent medicine, of more accurate resemblance, can be selected.

167

Thus if there occur, during the use of this imperfectly homoeopathic remedy first employed, accessory symptoms of some moment, then, in the case of acute diseases, we do not allow this first dose to exhaust its action, nor leave the patient to the full duration of the action of the remedy, but we investigate afresh the morbid state in its now altered condition, and add the remainder of the original symptoms to those newly developed in tracing a new picture of the disease.

168

We shall then be able much more readily to discover, among the known medicines, an analogue to the morbid state before us, a single dose of which, if it do not entirely destroy the disease, will advance it considerably on the way to be cured. And thus we go on, if even this medicine be not quite sufficient to effect the restoration of health, examining again and again the morbid state that still remains, and selecting a homoeopathic medicine as suitable as possible for it, until our object, namely, putting the patient in the possession of perfect health, is accomplished.

169^{Fifth Edition}

If, on the first examination of a disease and the first selection of a medicine, we should find that the totality of the symptoms of the disease would not be effectually covered by the disease elements of a single medicine - owing to the insufficient number of known medicines, - but that two medicines contend for the preference in point of appropriateness, one of which is more homoeopathically suitable for one part, the other for another part of the symptoms of the disease, it is not advisable, after the employment of the more suitable of the two medicines, to administer the other without fresh examination, for the medicine that seemed to be the next best would not, under the change of circumstances that has in the meantime taken place, be suitable for the rest of the symptoms that then remain; in which case, consequently, a more appropriate homoeopathic remedy must be selected in place of the second medicine for the set of symptoms as they appear on a new inspection.

169^{Sixth Edition}

If, on the first examination of a disease and the first selection of a medicine, we should find that the totality of the symptoms of the disease would not be effectually covered by the disease elements of a single medicine - owing to the insufficient number of known medicines, - but that two medicines contend for the preference in point of appropriateness, one of which is more homoeopathically suitable for one part, the other for another part of the symptoms of the disease, it is not advisable, after the employment of the more suitable of the two medicines, to administer the other without fresh examination, and much less to give both together (§ 272, note) for the medicine that seemed to be the next best would not, under the change of circumstances that has in the meantime taken place, be suitable for the rest of the symptoms that then remain; in which case, consequently, a more appropriate homoeopathic remedy must be selected in place of the second medicine for the set of symptoms as they appear on a new inspection.

170

Hence in this as in every case where a change of the morbid state has occurred, the remaining set of symptoms now present must be inquired into, and (without paying any attention to the medicine which at first appeared to be the next in point of suitableness) another homoeopathic medicine, as appropriate as possible to the new state now before us, must be selected. If it should so happen, as is not often the case, that the medicine which at first appeared to be the next best seems still to be well adapted for the morbid state that remains, so much the more will it merit our confidence, and deserve to be employed in preference to another.

171^{Fifth Edition}

In non-venereal chronic disease, those, therefore, that arise from psora, we often require, in order to effect a cure, to give several antipsoric remedies in succession, every successive one being homoeopathically chosen in consonance with the group of symptoms remaining after the expiry of the action of the previous remedy (which may have been employed in a single dose or in several successive doses).

171^{Sixth Edition}

In non-venereal chronic disease, those, therefore, that arise from psora, we often require, in order to effect a cure, to give several antipsoric remedies in succession, every successive one being homoeopathically chosen in consonance with the group of symptoms remaining after completion of the action of the previous remedy.

172

A similar difficulty in the way of the cure occurs from the symptoms of the disease being too few - a circumstances that deserves our careful attention, for by its removal almost all the difficulties that can lie in the way of this most perfect of all possible modes of treatment (except that its apparatus of known homoeopathic medicines is still incomplete) are removed.

173

The only diseases that seem to have but few symptoms, and on that account to be less amenable to cure, are those which may be termed one-sided, because they display only one or two principal symptoms which obscure almost all the others. They belong chiefly to the class of chronic diseases.

174

Their principal symptom may be either an internal complaint (e.g. a headache of many years' duration, a diarrhoea of long standing, an ancient cardialgia, etc.), or it may be an affection more of an external kind. Diseases of the latter character are generally distinguished by the name of local maladies.

175

In one-sided diseases of the first kind it is often to be attributed to the medical observer's want of discernment that he does not fully discover the symptoms actually present which would enable him to complete the sketch of the portrait of the disease.

176

There are, however, still a few diseases, which, after the most careful initial examination (§§ 84-98), present but one or two severe, violent symptoms, while all the others are but indistinctly perceptible.

177

In order to meet most successfully such a case as this, which is of very rare occurrence, we are in the first place to select, guided by these few symptoms, the medicine which in our judgment is the most homoeopathically indicated.

178

It will, no doubt, sometimes happen that this medicine, selected in strict observance of the homoeopathic law, furnishes the similar artificial disease suited for the annihilation of the malady present; and this is much more likely to happen when these few morbid symptoms are very striking, decided, uncommon and peculiarly distinctive (characteristic).

179

More frequently, however, the medicine first chosen in such a case will be only partially, that is to say, not exactly suitable, as there was no considerable number of symptoms to guide to an accurate selection.

180

In this case the medicine, which has been chosen as well as was possible, but which, for the reason above stated, is only imperfectly homoeopathic, will, in its action upon the disease that is only partially analogous to it - just as in the case mentioned above (§ 162, et seq.) where the limited number of homoeopathic remedies renders the selection imperfect - produce accessory symptoms, and several phenomena from its own array of symptoms are mixed up with the patient's state of health, which are, however, at the same time, symptoms of the disease itself, although they may have been hitherto never or very rarely perceived; some symptoms which the patient had never previously experienced appear, or others he had only felt indistinctly become more pronounced.

181

Let is not be objected that the accessory phenomena and new symptoms of this disease that now appear should be laid to the account of the medicament just employed. They owe their origin to it¹ certainly, but they are always only symptoms of such a nature as this disease was itself capable of producing in this organism, and which were summoned forth and induced to make their appearance by the medicine given, owing to its power to cause similar symptoms. In a word, we have to regard the whole collection of symptoms now perceptible as belonging to the disease itself, as the actual existing condition, and to direct our further treatment accordingly.

1) When they were not caused by an important error in regimen, a violent emotion, or a tumultuous revolution in the organism, such as the occurrence or cessation of the menses, conception, childbirth, and so forth.

182

Thus the imperfect selection of the medicament, which was in this case almost inevitable owing to the too limited number of the symptoms present, serves to complete the display of the symptoms of the disease, and in this way facilitates the discovery of a second, more accurately suitable, homoeopathic medicine.

183

Whenever, therefore, the dose of the first medicine ceases to have a beneficial effect (if the newly developed symptoms do not, by reason of their gravity, demand more speedy aid - which, however, from the minuteness of the dose of homoeopathic medicine, and in very chronic diseases, is excessively rare), a new examination of the disease must be instituted, the status morbi as it now is must be noted down, and a second homoeopathic remedy selected in accordance with it, which shall exactly suit the present state, and one which shall be all the more appropriate can then be found, as the group of symptoms has become larger and more complete.¹

1) In cases where the patient (which, however, happens excessively seldom in chronic, but not infrequently in acute, diseases) feels very ill, although his symptoms are very indistinct, so that this state may be attributed more to the benumbed state of the nerves, which does not permit the patient's pains and sufferings to be distinctly perceived, this torpor of the internal sensibility is removed by opium, and in its secondary action the symptoms of the disease become distinctly apparent.

184^{Fifth Edition}

In like manner, after each new dose of medicine has exhausted its action, the state of the disease that still remains is to be noted anew with respect to its remaining symptoms, and another homoeopathic remedy sought for, as suitable as possible for the group of symptoms now observed, and so on until the recovery is complete.

184^{Sixth Edition}

In like manner, after each new dose of medicine has exhausted its action, when it is no longer suitable and helpful, the state of the disease that still remains is to be noted anew with respect to its remaining symptoms, and another homoeopathic remedy sought for, as suitable as possible for the group of symptoms now observed, and so on until the recovery is complete.

185

Among the one-sided disease an important place is occupied by the so-called local maladies, by which term is signified those changes and ailments that appear on the external parts of the body. Till now the idea prevalent in the schools was that these parts were alone morbidly affected, and that the rest of the body did not participate in the disease - a theoretical, absurd doctrine, which has led to the most disastrous medical treatment.

186^{Fifth Edition}

Those so-called local maladies which have been produced a short time previously, solely by an external lesion, still appear at first sight to deserve the name of local disease. But then the lesion must be very trivial, and in that case it would be of no great moment. For in the case of injuries accruing to the body from without, if they be at all severe, the whole living organism sympathizes; there occur fever, etc. The treatment of such diseases is relegated to surgery; but this is right only in so far as the affected parts require mechanical aid, whereby the external obstacles to the cure, which can only be expected to take place by the agency of the vital force, may be removed by mechanical means, e.g., by the reduction of dislocations, by bandages to bring together the lips of wounds, by the extraction of foreign bodies that have penetrated into the living parts, by making an opening into a cavity of the body in order to remove an irritating substance or to procure the evacuation of effusions or collections of fluids, by bringing into apposition the broken extremities of a fractured bone and retaining them in exact contact by an appropriate bandage, etc. But when in such injuries the whole living organism requires, as it always does, active dynamic aid to put it in a position to accomplish the work of healing, e.g. when the violent fever resulting from extensive contusions, lacerated muscles, tendons and blood-vessels requires to be removed by medicine given internally, or when the external pain of scalded or burnt parts needs to be homoeopathically subdued, then the services of the dynamic physician and his helpful homoeopathy come into requisition.

186^{Sixth Edition}

Those so-called local maladies which have been produced a short time previously, solely by an external lesion, still appear at first sight to deserve the name of local disease. But then the lesion must be very trivial, and in that case it would be of no great moment. For in the case of injuries accruing to the body from without, if they be at all severe, the whole living organism sympathizes; there occur fever, etc. The treatment of such diseases is relegated to surgery; but this is right only in so far as the affected parts require mechanical aid, whereby the external obstacles to the cure, which can only be expected to take place by the agency of the vital force, may be removed by mechanical means, e.g., by the reduction of dislocations, by needles and bandages to bring together the lips of wounds, by mechanical pressure to still the flow of blood from open arteries, by the extraction of foreign bodies that have penetrated into the living parts, by making an opening into a cavity of the body in order to remove an irritating substance or to procure the evacuation of effusions or collections of fluids, by bringing into apposition the broken extremities of a fractured bone and retaining them in exact contact by an appropriate bandage, etc. But when in such injuries the whole living organism requires, as it always does, active dynamic aid to put it in a position to accomplish the work of healing, e.g. when the violent fever resulting from extensive contusions, lacerated muscles, tendons and blood-vessels requires to be removed by medicine given internally, or when the external pain of scalded or burnt parts needs to be homoeopathically subdued, then the services of the dynamic physician and his helpful homoeopathy come into requisition.

187

But those affections, alterations and ailments appearing on the external parts, that do not arise from any external injury or that have only some slight external wound for their immediate exciting cause, are produced in quite another manner; their source lies in some internal malady. To consider them as mere local affections, and at the same time to treat them only, or almost only, as it were surgically, with topical applications - as the old school have done from the remotest ages - is as absurd as it is pernicious in its results.

188

These affections were considered to be merely topical, and were therefore called local diseases, as if they were maladies exclusively limited to those parts wherein the organism took little or no part, or affections of these particular visible parts of which the rest of the living organism, so to speak, knew nothing.¹

1) One of the many great and pernicious blunders of the old school.

189

And yet very little reflection will suffice to convince us that no external malady (not occasioned by some important injury from without) can arise, persist or even grow worse without some internal cause, without the co-operation of the whole organism, which must consequently be in a diseased state. It could not make its appearance at all without the consent of the whole of the rest of the health, and without the participation of the rest of the living whole (of the vital force that pervades all the other sensitive and irritable parts of the organism); indeed, it is impossible to conceive its production without the instrumentality of the whole (deranged) life; so intimately are all parts of the organism connected together to form an indivisible whole in sensation and functions. No eruption on the lips, no whitlow can occur without previous and simultaneous internal ill-health.

190

All true medical treatment of a disease on the external parts of the body that has occurred from little or no injury from without must, therefore, be directed against the whole, must effect the annihilation and cure of the general malady by means of internal remedies, if it is wished that the treatment should be judicious, sure, efficacious and radical.

191

This is confirmed in the most unambiguous manner by experience, which shows in all cases that every powerful internal medicine immediately after its ingestion causes important changes in the general health of such a patient, and particularly in the affected external parts (which the ordinary medical school regards as quite isolated), even in a so-called local disease of the most external parts of the body, and the change it produces is most salutary, being the restoration to health of the entire body, along with the disappearance of the external affection (without the aid of any external remedy), provided the internal remedy directed towards the whole state was suitable chosen in a homoeopathic sense.

192

This is best effected when, in the investigation of the case of disease, along with the exact character of the local affection, all the changes, sufferings and symptoms observable in the patient's health, and which may have been previously noticed when no medicines had been used, are taken in conjunction to form a complete picture of the disease before searching among the medicines, whose peculiar pathogenetic effects are known, for a remedy corresponding to the totality of the symptoms, so that the selection may be truly homoeopathic.

193

By means of this medicine, employed only internally (and, if the disease be but of recent origin, often by the very first dose of it), the general morbid state of the body is removed along with the local affection, and the latter is cured at the same time as the former, proving that the local affection depended solely on a disease of the rest of the body, and should only be regarded as an inseparable part of the whole, as one of the most considerable and striking symptoms of the whole disease.

194

It is not useful, either in acute local diseases of recent origin or in local affections that have already existed a long time, to rub in or apply externally to the spot an external remedy, even though it be the specific and, when used internally, salutary by reason of its homoeopathicity, even although it should be at the same time administered internally; for the acute topical affections (e.g., inflammations of the individual parts, erysipelas, etc.), which have not been caused by external injury of proportionate violence, but by dynamic or internal causes, yield most surely to internal remedies homoeopathically adapted to the perceptible state of the health present in the exterior and interior, selected from the general store of proved medicines,¹ and generally without any other aid; but if these diseases do not yield to them completely, and if there still remain in the affected spot and in the whole state, notwithstanding good regimen, a relic of disease which the vital force is not competent to restore to the normal state, then the acute disease was (as not infrequently happens) a product of psora which had hitherto remained latent in the interior, but has now burst forth and is on the point of developing into a palpable chronic disease.

1) Foot-note in Fifth Edition only:     As, for instance, aconite, rhus, belladonna, mercury, etc.

195

In order to effect a radical cure in such cases, which are by no means rare, after the acute state has pretty well subsided, an appropriate antipsoric treatment (as is taught in my work on Chronic Diseases) must then be directed against the symptoms that still remain and the morbid state of health to which the patient was previously subject. In chronic local maladies that are not obviously venereal, the antipsoric internal treatment is, moreover, alone requisite.

196

It might, indeed, seen as though the cure of such diseases would be hastened by employing the medicinal substance which is known to be truly homoeopathic to the totality of the symptoms, not only internally, but also externally, because the action of a medicine applied to the seat of the local affection might effect a more rapid change in it.

197^{Fifth Edition}

This treatment, however, is quite inadmissible, not only for the local symptoms arising from the miasm of psora, but also and especially for those originating in the miasm of syphilis or sycosis, for the simultaneous local application, along with the internal employment, of the remedy in diseases whose chief symptom is a constant local affection, has this great disadvantage, that, by such a topical application, this chief symptom (local affection)¹ will usually be annihilated sooner than the internal disease, and we shall now be deceived by the semblance of a perfect cure; or at least it will be difficult, and in some cases impossible, to determine, from the premature disappearance of the local symptom, if the general disease is destroyed by the simultaneous employment of the internal medicine.

1) Recent itch eruption, chancre, condylomata.

197^{Sixth Edition}

This treatment, however, is quite inadmissible, not only for the local symptoms arising from the miasm of psora, but also and especially for those originating in the miasm of syphilis or sycosis, for the simultaneous local application, along with the internal employment, of the remedy in diseases whose chief symptom is a constant local affection, has this great disadvantage, that, by such a topical application, this chief symptom (local affection)¹ will usually be annihilated sooner than the internal disease, and we shall now be deceived by the semblance of a perfect cure; or at least it will be difficult, and in some cases impossible, to determine, from the premature disappearance of the local symptom, if the general disease is destroyed by the simultaneous employment of the internal medicine.

1) Recent itch eruption, chancre, condylomata, as I have indicated in my book of Chronic Diseases.

198

The mere topical employment of medicines, that are powerful for cure when given internally, to the local symptoms of chronic miasmatic diseases is for the same reason quite inadmissible; for if the local affection of the chronic disease be only removed locally and in a one-sided manner, the internal treatment indispensable for the complete restoration of the health remains in dubious obscurity; the chief symptom (the local affection) is gone, and there remain only the other, less distinguishable symptoms, which are less constant and less persistent than the local affection, and frequently not sufficiently peculiar and too slightly characteristic to display after that, a picture of the disease in clear and peculiar outlines.

199

If the remedy perfectly homoeopathic to the disease had not yet been discovered¹ at the time when the local symptoms were destroyed by a corrosive or desiccative external remedy or by the knife, then the case becomes much more difficult on account of the too indefinite (uncharacteristic) and inconstant appearance of the remaining symptoms; for what might have contributed most to determine the selection of the most suitable remedy, and its internal employment until the disease should have been completely annihilated, namely, the external principal symptom, has been removed from our observation.

1) As was the case before my time with the remedies for the condylomatous disease (and the antipsoric medicines).

200^{Fifth Edition}

Had it still been present to guide the internal treatment, the homoeopathic remedy for the whole disease might have been discovered, and had that been found, the persistence of the local affection during its internal employment would have shown that the cure was not yet completed; but were it cured on its seat, this would be a convincing proof that the disease was completely eradicated, and the desired recovery from the entire disease was fully accomplished - an inestimable, indispensable advantage.

200^{Sixth Edition}

Had it still been present to guide the internal treatment, the homoeopathic remedy for the whole disease might have been discovered, and had that been found, the persistence of the local affection during its internal employment would have shown that the cure was not yet completed; but were it cured on its seat, this would be a convincing proof that the disease was completely eradicated, and the desired recovery from the entire disease was fully accomplished - an inestimable, indispensable advantage to reach a perfect cure.