Richard Haehl: exposition on Miasms and Chronic diseases.

This is one of the most beneficial summations of Hahnemanns writings available to the genuine practitioner.

HAHNEMANN  would not have  been  the  keen observer we have known him, if he had not noticed  in the  course of years with ever increasing clearness,  that  the structure of his therapeutic system lacked the final coping stone.    It  is true that his homoeopathic system offered, as he himself  states, ” far  more certain,  more convenient  and less harmful “ remedies than allopathy  for acute diseases,  for epidemic diseases,sporadic fevers, and venereal diseases.  ” But the number  of the tiresome diseases yet  in the wide world was incomparably greater,” and in  spite of all homoeopathic experiments  they  were still uncured.

The treatment of such  diseases was, “even when carried out strictly in accordance  with the theory of  the homoeopathic science,  as hitherto practised,  encouraging in the beginning, less favourable in the continuation and hopeless in the end.”

“the years 1816 and 1817, I have been employed, day and night, with the very serious problem of finding out why all the medicines known to homoeopathy, bring  about no real cure in  the diseases under discussion and of securing, if  possible, a clearer insight into the true state of those thousands of stricken ones, who remain uncured in the face of the unimpeachable truth of the homoeopathic system of healing. Lo ! in this  time the Giver  of all  good things suffered  me to solve this sublime riddle for mankind’s good as a result of incessant thought. tireless investigation, accurate observation and the most  careful experiments.”

These are Hahnemann’s words  in the first part of his last  considerable medical  work :  “Chronic  Diseases,  their nature and homoeopathic  treatment ” (I. Edition, Arnold, Dresden and Leipsic,  1S2S ; II. Edition, 1835 to 1839).  And in a footnote he adds :

Yet of all these indescribable labours I did not so much as breathe a word either to the world in general or to my students.  This was not perchance because the ingratitude frequently shown me restrained.   .   .  No, I did not breathe a word of it, because it is improper and even injurious to speak and write of immature things.   Only in the last year have I communicated the main facts to two of my students, who have done most meritorious service on behalf of homoeopathy. This  was for their good and that of their patients, and that the whole of this scientific knowledge should not  be lost to the world in the event of a higher call into eternity before the completion of my book—which was not improbable in my seventy-third year.”

The two students, of whom Hahnemann here speaks, were Dr. Stapf, of Naumburg, the publisher of the  ” Archive for the Homoeopathic Science of Healer” and his co-publisher, Dr.  Gross,  of Juterbogk, Hahnemann’s sponsor.  These two, who stood nearest  his heart and who had penetrated furthest into his new system of healing, were, in fact, the first doctors to whom he  entrusted  his new discovery.  But  some  years  before (1823) he had told an enthusiastic  supporter of his theories, who  had been  cured  of a chronic disease of long standing (the Consul General for Prussia. Dr. Friedrich Baumgartner,  of Berlin),  how he  had  endeavoured to  cope effectually  with chronic diseases.  At that time he still hoped to be able to test his theory in a hospital of his own in Kothen (there was none in the town) and to be able to prove  its truth to his students by actual  fact.  For he was doubtful whether he would  be able by  means  of  the written word to  make  generally  comprehensible  all that  he had  investigated  and ascertained in the course of years concerning the nature of chronic diseases.

His hope of a hospital of his own in Kothen was not  fulfilled.  His patron, Duke Ferdinand, whom he had approached in the matter, was probably not in a position to satisfy this desire  of his Physician-in-ordinary, in view of the continuously precarious financial position of his estates (and particularly in view of  the violent resistance of  his medical authorities of which he had full cognisance).  Consequently Hahnemann kept his new  discoveries  to himself for several years, making use of them only in his own practice  and, according to his own story, achieving eminent and remarkable  cures in cases where formerly his  own well-chosen remedies had failed .  At last, when his intuitions gained by  inexhaustible investigation had become certainties to himself,  when these new views and ideas seemed to be sufficiently matured. he determined on their communication to others, on their written deposition in a well-ordered form.  His old publisher, Arnold of Dresden, undertook the publication of the work.  The first edition  consists of four parts in all ; the second of five.  Part I contains the general theoretical principles of the new theory about chronic diseases ; Parts II  and IV and some of Part V contain a detailed presentation of the most important antipsoric remedies.

We shall return later to the fate of the book on  the market. Few books have stirred up  more excitement in the medical  world than Hahnemann’s ” Chronic  Diseases.” His conception of these  diseases  and, in particular, his Psora Theory aroused the criticism  of friend and foe to a tremendous extent from  the very  moment of their  publication.   At  this point many of his adherents and students refused to follow him any further. To his opponents these views of his  seemed to be even more idiotic than the high dilution medicines of homoeopathy and for nearly a  century they have formed the target of  their scornful ridicule.  This should therefore justify us in proceeding  to treat at some length the contents of this last  medical work of considerable size, given by Hahnemann to the world.   The modern medical scientific world is once more evincing a sharper sense of the deeper fundamentals  of  disease  than  was  possible  for  decades past  under  the tyrannous  prejudice  of  materialistic-bacteriological  views,  and we  may perhaps succeed in making clear to it what Hahnemann really wished to say.

Perhaps the moderns will recognise the true kernel of enduring value, which, enveloped in much that is incomprehensible, vague, untenable and obsolete, is contained in this work by a more  than seventy years old explorer of rare acumen.

The starting point for the main ideas of the book was the observation, that certain  chronic diseases of venereal  origin and otherwise,  could  be alleviated by  homoeopathic remedies,  but not  completely cured.  Special conditions, such as serious dietary mistakes, cold, wet and stormy weather, temperamental influences,  etc., caused the apparently rectified  troubles to appear again, frequently with new and  stubborn  symptoms.   New remedies, chosen in the best and most careful  way, were again of avail, “but only slightly and  imperfectly” for a short time, until  the next outbreak was brought  on by adverse external  influences.  On the  other hand,  under favourable, external conditions, such as a change of climate and home, careful diet, etc., a  “remarkable truce “  was observed.  Considering all things, however, the chronic malady was never eradicated, but became  worse from year to year, often with the most varied external symptoms.

At first it  was thought that the reason for failure of  the homoeopathic treatment might be found in the insufficient number of remedies proved and that the prospects would change for the better the more accurately proved medicines the physician had  at his disposal.  But although  this proved to be some consolation for the students, the Master  could not rest satisfied with. Day and night, he  was occupied with the question why the ordinary, carefully selected remedies did not produce a lasting cure. At last he came to the conclusion that, “in chronic diseases one has always to deal with a segregated part of a deeper lying original evil, the large extent of which  is  shown  by new symptoms arising from  time to time.   .  .  .  But the original evil  sought must also be of a miasmatically chronic nature—as was  perfectly evident  to me  from the fact that, once it had developed to a certain degree of intensity, it could not be eradicated by the mere vigour of a robust constitution. Neither could it be overcome by the  healthiest  diet and order of life, nor annulled by itself, but in the course of years it grew worse, with the addition of other more serious symptoms—right up to the end of life.”

From frequent observations, Hahnemann had discovered that chronic maladies,  which would not completely yield  to the  usual homoeopathic remedies, had some connection with a “previous outbreak of psora.” Itch,  a  skin disease  caused by the itch insect, was then of  far greater importance than nowadays.  It  was extraordinarily widespread  among the common  people.  Although  external  treatment with salves, etc., often disposed very quickly of the external symptoms, all kinds of obstinate evils would follow in its train,  and these often  could not be subdued for years. Hahnemann was not alone in his  view of  the  connection between chronic maladies and “expelled  itch”.  Two decades before  the appearance of his ” Chronic  Diseases,”  Autenrieth, a University  Professor of Tubingen,had  referred to this  (” Tiibinger  Blatter  fiir  Naturwissenschaft und,” Vol. II, 2nd Part).* In quotation of the contents we adhere to the .md  Edition of the work ; it is more complete in several passages. Of Autenrieth’s observations Hahnemann says: “When I was compiling my first edition of “Chronic Diseases”, I  did  not know of Autenrieth’s  experiments  in  practical therapy in the clinics of Tubingen in 1808.   But what he says about the diseases after the local expulsion of itch is, as I then saw, merely a confirmation of what I had  already found in a hundred other writers.  He, also, has noticed many diseases resulting from this external dislodgment of itch—ulcers  of the  foot, phthisis, hysterical chlorosis, with various menstrual complications,  white  swelling  of  the  knees,  dropsy  of the  joints,  epilepsy, amaurosis with  discolouration of the cornea,glaucoma with gutta serena, mental disturbances, paralysis, strokes curvature of the neck, etc.  All of these he attributes (quite  wrongly) to the salves.  But his own slow method of local dislodgment (which he foolishly calls curing) with liver of sulphur  and soft soap is not a whit better.  The absurdity of thinking that his method is not just as much  a local dislodgment of the itch eruption from the skin! He knows as little about really effective help as all the rest of  the allopaths, when he writes :  ” It is indeed ridiculous to think  of curing itch  (scabies) by internal remedies.’* No! it  is not only ridiculous, it  is pitiable not to think of learning a sure  and  thorough cure by internal remedies of this internal itch malady, which is not to be cured by local expulsion.” As time went on, Hahnemann was more and more convinced, as a result of his observations, that the most diverse diseased conditions of the human body—from warts on the finger to the largest encysted tumours, from mal-formation of the finger-nails to swelling of the bones and curvatures of  the spine, “in a word, that thousands of wearisome human troubles, labelled with various names by pathology, are—with few exceptions—solely the true descendants of the polymorphous psora   .  .   .  and only partly expressions of the old chronic eruptive and itch miasma “ (sycotic and venereal diseases excepted).And in another place he says :

All chronic diseases of man—even those which are left  to them-selves  and are not aggravated by wrong treatment—betray great persistence and endurance.  Unless they  are  thoroughly cured  by medical science, before or when they are fully developed, they become more and more acute as time goes on and for the whole course of  life they cannot  be lessened, still less overcome and eradicated by  the power  of a  nature, however robust, or  of a manner of  life  and diet  however healthy.  They will therefore  never pass   away  of themselves, but will grow and vitiate themselves  until death supervenes.Consequently they must, all of them, have as their fundamental origin firmly  established chronic miasms, by  which means their  parasitical existence in the human organism can be continually strengthened and increased.”

According to Hahnemann, there are in Europe only three chronic miasms, the diseases of which are distinguished by local symptoms and from which most, if not all, chronic ailments originate :

Sycosis, or fig-wart disease.

  1. Syphilis or venereal chancre  disease,  and
  2. Psora,  which  is at the bottom of the itch Hahnemann’s opinion an important cause of chronic diseases.

Syphilis and  to a  greater extent Psora occur far  more frequently.  Sycosis is not always prevalent in an equal amount, but  fluctuates considerably.  For example, during the French wars, from 1809 to  1814, it was very widely propagated, but since then it has been much  less frequent.Hahnemann  then goes on  to describe the multi-shaped, wart-like and cauliflower-like excrescences from the urethra on the glands and prepuce in the male  or around the genitals in  the female, such  as are so frequently encountered in gonorrhoeal diseases.  He repudiates local removal  and external destruction of  these growths by  ligatures, excisions or corrosions,as well  as the senseless internal application of mercury,  which does not influence or diminish in the slightest  the sycotic miasm.The surest and most thorough cure for this sycotic miasm the gonorrhoea and all its excrescences, and therefore for the whole of the sycosis, is obtained by applying internally the sap  of the Tree of Life (Thuja) in 30th potency as indicated homoeopathically.  In certain cases  to be followed later by Acidum Nitricum.  Only in the most  advanced  and  serious  stages would it be necessary ” to paint the larger  warts once a day with the mild sap, pressed from the green leaves of the Thuja, mixed in  half  proportion with spirits of wine “

But  if  the  sycosis is  complicated with  syphilis  or even with  psora, then, first of all, the worst constituent, namely, the psora,  must be treated with anti-psoric remedies.  Only after that should the  anti-sycotic remedies be used and last of  all ” the suitable dose  of the best mercury preparation ” should be  prescribed for the syphilis.  This  treatment must be repeated,when necessary, until the cure is complete, in the order named.

But one must be sure to allow each  of these three kinds of medicine enough time to complete its own effect.

With remarkable perspicacity  Hahnemann realised  that  gonorrhoea, i.e.  sycosis or fig-wart  disease, is a separate disease,  not  connected with syphilis and that it is caused  by a specific virus.   He thus stood in direct contrast to his famous English contemporary, John Hunter, who, as is well-known,  took up the point of view that there was  only one venereal  poison. According to the constitution and physical nature of  the man this poison caused in one  subject gonorrhoea,  in a  second a soft chancre and  in  a third a hard  chancre.   Even until sixty years  ago, Hunter’s  confusing theory  of  the unit}’ of  sexual diseases remained  common property of physicians, and homoeopathy’s founder was severely reproached for having dared to set up open defiance of so important an authority as John Hunter.After nearly one hundred years of serious research in the laboratory and at the sick-bed, we know that Hahnemann was quite  right, that in reality gonorrhoea and syphilis are totally different diseases and that their bacteria have nothing at all  to do with one another.  Wliilst gonorrhoea  arises from the gonococcus discovered by  Neisser, the soft chancre is caused by rod-like bacteria, grouped in chain formation and the virus  of the hard chancre,so-called syphilis, is the spirochaeta pallida Schaudinn.

Further, in regard to the method of treating gonorrhoea, modern researches have resulted in valuable confirmations  of the accuracy of Hahnemann’s intuitive conceptions. Right up to our own time gonorrhoea was considered by  the old school to be a local malady  and was  therefore treated  almost entirely by local measures. In the medicine  of to-day it has been acknowledged that gonorrhoea may cause serious deterioration of the bodily fluids and disturbance of the general state of health, and that local treatment may not infrequently be followed by a latent continuation of gonorrhoea, lasting for years and tens of years.   It  is a logical conclusion  from the above which induces the modern medical  world to endeavour to supplant purely local measures by a treatment guided more by biological principles. How  nearly the old  school has  gradually  approached  Hahnemann’s conception of the nature and treatment of gonorrhoea may be shown by the concluding words of a recent essay (January, 1922) on  “Gonorrhoea as a Chronic Malady ” (Med.  Clinic,  1922, Xo.  3, p. 67), by Dr. E. Langer, a student of the Berlin professor, Dr. Buschke : Our therapeutic armoury, of which only the principal parts are mentioned here,  is  tremendous, but on the  other hand the results achieved are very modest.  With  gonorrhoea,  too, we have to deal in a considerable number  of  cases with a deep-seated general  disease,which we can never or very rarely track to its lair.  For the future, the only thing to do is to seek a way of attacking the disease in its point of localisation according to biological laws .According to Hahnemann’s theory of chronic diseases, SYPHILIS is another frequent  source of tedious illness. In its importance and frequency it exceeds sycosis considerably. In the following words, Hahnemann states his conception of the nature of syphilis : “In  impure coition  the  specific  infection probably takes  place instantaneously at the point of contact and friction.When the infection has taken hold, the whole living body is overcome with  it.   Directly  after the moment of  infection the formation  of venereal disease begins in the whole of the interior.   .   .  .   It is only after this penetration of the evil received into all the organs, only when the transformation of the whole man into a venereal subject  … is complete  .   .  .   that the morbid state tries to ease  and to palliate the internal evil by producing  a  local symptom  (called a chancre), which first appears as a blister and  then breaks out into a painful sore.

On the basis of this conception Hahnemann repudiates with the greatest severity local treatment and “removal “ of the chancre, and in support he quotes passages from  the writings of  various celebrated contemporaries, amongst  others, John  Hunter, and the Frenchman, Fabre. From  these utterances it becomes quite clear that they also regarded local treatment and removal of the chancre sore as quite purposeless, since a cure of the venereal disease could never  be obtained in this way. On the contrary, “if it is not cured, it becomes worse from year to year to the end of life, and even the most robust constitution cannot destroy it in itself.” The chief remedy is the best mercury preparation in the finest dilution.

This treatment of syphilis with small doses of mercury not to be repeated too often is still to-day regarded as the best by many homoeopathic doctors. From old school medicine partisans, however, complaints are raised declaiming against the enormous quantities of  mercury hitherto usual because of the lasting and  dangerous after  effects.   Many physicians make use of the mercury-containing spring of San Anton and laud its effectiveness, although according to  Professor Dr. E.  Hintz  it  contains  only 0.0000016  gr.  o fhydragyrum bichloratum to i Kilo, a quantity amounting to about the 8th decimal potency.  Professor Dr. Kionka (Jena), who likewise recommends the use of this mineral spring containing  mercury, expresses himself in the following  words, which  offer a pleasing contrast  to the derisive comments of so many physicians  concerning  the homoeopathic treatment of syphilis : Schade’s researches make it probable that the effect of mercury on syphilis is a catalytic one and such people as are in agreement with this view will be guided in their therapeutic efforts in the disease by the desire to extend the mercury cure over as long a time as possible But in order to produce such a (fermentative) effect, it  is sufficient to have the smallest quantity of  the substance  concerned in the body, provided that  it circulates therein in  a suitable form.  .  .   .  We must also draw attention to discoveries of former times which have apparently fallen into oblivion.  According to  them, quite small quantities of mercury given over a long period, improve the state of health. Hahnemann’s views about the nature and treatment of syphilis coincide almost perfectly with our modern theories,  except that we  are a century richer  in  experience. On  the  other hand,  we  know  now  that  the number of  diseases directly consequent  on  syphilis is far greater than Hahnemann and his contemporaries  suspected. On the other hand, we have learned  from experience that  syphilis is a much more obstinate disease than Hahnemann had formerly  imagined.  Many of his assertions in this respect have been refuted by new observations and experiences and one would scarcely hope to find in these days a homoeopathic doctor who would be content to abide by the following definite statements made by Hahnemann : ” There  is no chronic miasm, no chronic  disease springing from a miasm, which can be more easily cured than this.Only one single small dose of the best mercury remedy is requiredto cure thoroughly and for  ever the whole syphilis  and its chancre within a fortnight.   .   .   .   The chancre, not treated with external remedies, would never be healed if the internal syphilis had not been first  of all completely annihilated and  extinguished by the mercury dose.” If Hahnemann had been able to see  the  convincing  after-effects of uncured syphilis, often only  appearing after tens of years, he, who was so extraordinarily conscientious a  physician, would have expressed  himself more cautiously about the healing of venereal disease.

Sycosis and syphilis, however, are very much less significant as a cause of chronic diseases when compared with psora:

Psora  it is, that oldest, most universal, most pernicious and yetthat least  known chronic miasmatic disease, which has been deform-ing and torturing the nations for thousands of years.” Seven-eights of all  the  chronic maladies prevalent are  ascribed by Hahnemann to Psora, whilst  the remaining eighth originates in syphilis and sycosis or a complex combination of these two  miasmatic  chronic diseases or of all three.

“I will quote here a few of those innumerable experiences which have been left for our guidance, and which I could increase by an equal number of my own observation (were the former not sufficient and to spare !), and  thus I will show how ravenously the internal psora rageswhen it is deprived of  the  local symptom,  the skin eruption, which serves as a palliative for the evil dwelling within.”

Then he accompanies his statements with nearly a hundred cases of the disease taken from writers in all centuries. In every case severe bodily or mental suffering followed the  removal  of  a  skin  eruption  by  external remedies.  In this collection we see the most diverse skin diseases grouped with itch, scald head, various kinds of lichen, leprosy, swollen glands  of the neck and facial eruptions. This is certainly sufficient proof of how widely Hahnemann understood the term ” itch ” or ” psora.”

He has been reproached for quoting so many  medical writers in favour  of his ” psora ” theory without supporting his views  by the description of cases which he himself had observed.  He  repudiates this  reproach when he says : “Truly !  if the examples I have here quoted from the older and more modern non-homceopathic writers are not conclusive testimony enough, I should like to know which others could be considered more conclusive (my own not excepted) !  How often (I should say myself,almost always) have not our opponents of the old school denied credence in the observations made by honourable homoeopaths, because they were not completed before their eyes and because the patients’ names were only indicated by a letter.”

PSORA , a  common  expression that  was widely  known in Hahnemann’s time, was the general term for a whole  series of  skin troubles of the most varied kinds, well known from the  very earliest  times.   It was in this  wider sense that  contemporaries (e.g.  Autenrieth, Schonlein, etc.) used the word generally at the end of the eighteenth  and in the first  three decades  of the nineteenth century, although at the same time they applied it in the narrower sense to itch proper. Hahnemann did not therefore coin this expression, but rather by his use of it showed his association  with his contemporaries.  It is  important to establish this with some emphasis.  Like them he used the word in a wider sense, in spite of the fact that, like them, he  knew the cause  of itch—the itch mite (Acams  scabiei or Sarcoptes hominis), its destruction by external remedies (embrocation, baths, etc.) and the digging out of the  mite from its burrows under the skin.  He  shared also the view of his contemporaries that the itch eruption could only develop on a favourable fostering ground, called” Internal psora.”   The latter, however, was not cured with the destruction or removal of the  mites,  although of course it was necessary  first of all to remove the parasite.  Thus far, Hahnemann’s theory coincides exactly with that  of the  Tubingen Professor Autenrieth   and his celebrated  student Schonlein of Wurzburg.  Psora,  ” the internal itch,” was totally different in his opinion from the external ailment, the primary eruption.  The latter could be cured quickly and easily, whilst the internal psora, often remaining latent for a long time and only showing secondary symptoms  as a result of special factors, was a wearisome disease.  In 1S29 he wrote to Dr. Schreter,of Lemberg, entirely in this strain  (Neues Archiv (Stapf),  1847, 3fd Vol.,2nd Part, pp. 181  and 183) :

“What the allopaths could not expel by sulphur or mercury ointments was no primary itch eruption at all, for that disappears with such ointments in two days and often in a few hours.  No !  that was definitely a secondary eruption, a real case of developed psora, which was showing itself in eruption as in so many cases.  Do not be surprised that you could not  easily get rid of these psora cases which are often so vicious.”  (June 19th,  1829.)

“And :In newly contracted itch (internal psora, which has developedinto chronic diseases and eruptions, is very different from that. in fact,that is the primary state  whilst the other is the secondary and worse state !) in a case of this itch, newly infected, you will obtain easy successby treating with a mild sulphur remedy.”  (September 12th, 1S29.)

But in another place (and this contrasting attitude must be emphasised) Hahnemann maintains that psora, internal itch, is only brought about by the external disease of itch and the latter’s hasty removal.  Psora will remain for life if it is not cured by the physician’s art.

“However slight  the  internal psora  may  be at the time of the removal of this itch eruption, appearing only as a few blisters, yet as is shown by the subsequent indispositions and ailments, frequently not too serious, the internal psora remains.   Although it may be slight it is the general psoric malady of the whole organism and cannot be eradicated without the help of science.  Continually increasing to the end of life, the  vigour alone of even the finest and most robust physical constitution cannot  overcome it.   .   .  .   For years the psora latent in the body may be slumbering and the patients suffering from it may give the impression of being perfectly  healthy.   .   .  .  Often it does not betray its  presence for years by marked symptoms, which might suggest a serious  disease.   .  .   .   Internal itch is of such a peculiar nature that, under favourable external circumstances, it may remain for a long time, as it were, suppressed and covered over, and the patient appears to the superficial  observer to be healthy.  .   .   .  This may remain for years, often for many years, until unfavourable circumstances for mind and body or for both occur sometime and this seems to act as a hostile impulse  to the latent internal evil to arouse  it and bring its germs to development. Then the friends, the doctor and the patient himself cannot understand why his health has so suddenly gone to ruin.

To Hahnemann psora is a disease or disposition to disease, hereditary from generation to generation for thousands of years and it is the fostering soil for every possible diseased  condition.  At the same time it  is the most infectious of all.  Contact with  the general external skin is quite sufficient for transference of the disease in contrast with sycosis and syphilis, in which cases a certain amount of friction on the tenderest parts of our bodies, where most  nerves are congregated and where the cuticle  is thinnest, is requisite for infection.  But  everyone   is  exposed to  psora  almost  under  any circumstances :“The  hermit on Montserrat in his rocky abode can  escape it as little as the young prince in his cambric swaddling clothes.”

Hereditary transmission for thousands of years has, of course, generated an increasing number of the forms of disease, so that their polymorphous symptoms are nowadays almost innumerable. Hahnemann says that psora, breaking out from its latent state, can be observed in the most variable forms imaginable, according to the bodily constitution, the deficiences of up-bringing, the  habits, the mode  of occupation and the external conditions  of  the individual.  An unusually large number of diseases, stated in the pathology of the older school to be definitely self-existing, are simply “the characteristic,secondary symptoms of the  underlying miasmatic malady now  coming to light—namely psora, this thousand  headed monster  so  long undiscovered,so pregnant with misery.” Together with nearly one hundred cases of disease,  taken from medical writers of  every  age in  support  of his  contention   (see  above),  he enumerates on thirty-two pages (pp. 67-98) all the manifold  manifestations of psoric diseases.  An astonishing number of ailments, apparently having no connection  with  one  another,  meets us  here;  variations  of  the general state  of  health  and  of the  temperament, disturbances  in the control of thought and  in the mnemonic capacity,  headaches,  marked dryness and brittleness of the skin together with scurf and loss  of hair, mutation   of  complexion,  interference with   sight  and  hearing, painful sensibility of certain parts of the body  to  pressure, small sores on the lips, increasing decay of the teeth, catarrhal ailments of the upper  and lower trachea, difficulties in breathing, disturbances of stomach and  bowels, rheumatic ailments, feeling of severe cold or  extreme  sensibility to heat, boils, ulcers, warts and encysted  tumours, skin easily disposed to perspire, increased  tendency to  catch cold, disturbances of sleep with vivid  dreams,etc., etc.   ” One might almost ask in desperation :  ‘ What is there not ? ‘ “as  a modern  professor,   Krehl,  of Heidelberg,  exclaims  in  discussing “Arthritis ” and its numerous symptoms.   And yet ” Arthritis,”  caused by excess of uric acid, is a much narrower conception than that of Hahnemann’s psora! The individual physical constitution is  the varying factor, which makes it  more or less difficult for  the  physician to correlate  all these  symptoms in their  proper nature and connection.   Hahnemann  boasts  that  he is exceptionally well fitted to discover  psora in its many  forms  because he himself never had a psoric constitution.  In a footnote to p. 57 he says : “To me it was more possible than to many hundreds of others todiscover and recognise by careful comparison of the condition of  all those affected by it, the signs of psora, whether it were still slumbering and  latent in the interior or whether it had been aroused from with into serious chronic maladies.  For I, which is  very rare, was  never psoric and consequently, from my birth  to my present eightieth year, I have always remained perfectly immune  from all these ailments. This is in spite of the fact that I  am very sensible to acute epidemic diseases   and that I  suffer many  mental labours and innumerable temperamental difficulties.” On the same subject he  wrote to Dr.  Wislicenus, of Eisenach,  on the 30th March, 1825: “these extremely enigmatic problems the one circumstance that helped me considerably was the  fact that, from  my birth onwards,I had always been free from every trace of the psora poison. On that account I could  the  more certainly  detect the difference  noticeable between psora and absence of psora. One single small boil is sufficient to mark  down a man as psoric. The man uninfected with psora, never bleeds from the nose unless he has had a blow on it.”

And  now as to the treatment.  In Hahnemann’s  opinion psora will cure itself as  little as syphilis.  The whole skill of the physician is necessary to come to the aid of its polymorphous forms and it  is only  possible on the basis of  the law of similars.  Above all there is one remedy, which seems suited to the  condition of psora and  that  is  Sulphur.   Hahnemann saysthat  in  drawing up a list of the symptoms observed in psoric  patients, their striking coincidence with the medicinal effects of Sulphur had been remarkable. The first therapeutic principle, stated by Hahnemann in  his ” ChronicDiseases ”  for psora,  to which by the way the greater part of the book is devoted, demands  that  no  skin eruption shall be  removed by external remedies.This is quite understandable since to him the skin eruption is not a local symptom at all, not a disease in itself but  simply a sign of  internal unhealthiness  or disorder—in fact, a sign of psora.   He says :

“If  the . physician  desires  to  proceed  in a  conscientious  and intelligent manner, no skin eruption, whatever its nature, should be removed  by  external  remedies.  The  human skin cannot  withoutthe help of the rest  of  the  living  body produce  from  itself  an eruption.  It will never become diseased in any way unless the general diseased condition, the abnormal state of the whole organism,  compels In every case an improper condition  of the whole  body, of the inner living organism,  is  at the  root  of the  trouble and therefore this must first be considered and  should  be  removed  by  internal medicines, which will alter, improve and  cure  the whole.  Thereupon the eruption,  depending  for existence on the internal disease,  will cure  itself  and  disappear—often  more  speedily  than  by external remedies. With  newly infected adults treatment with internal remedies for several weeks and without any external remedies at all, will be sufficient to destroy the internal and external psora.  In the case  of a newly infected  child, the administration of one or two pellets of the size of a poppy seed moistened with potentised Sulphur in spirits of wine will be quite sufficient to breakup completely and cure the whole of the itch—eruption and inner itch disease (psora) as well, whilst all external remedies are absolutely avoided.”

In the same way as Hahnemann had designated Thuja as the chief remedy for sycosis and Mercurius for syphilis, he here advocates Sulphur as the most effective agent against psora.  It is quite true that large doses of this remedy will not attain their object whether applied internally or externally.  Large doses of Sulphur either bring about deterioration of the state of health or else they are simply expelled by vomiting or diarrhoea without the body being able to avail itself of its curative power. But in the majority of instances Sulphur is not sufficient by itself to cure thoroughly  the psora.   Very  often several remedies are necessary, and in the worst  cases  a large  number are required in succession, if  “this tremendous army of psora  symptoms “  is  to be dominated and a cure effected.  Consequently, the  larger part  of the work, four volumes of the second edition, concerns itself exclusively with a presentation of the anti-psoric medicines and their effects.  But it is quite evident that Hahnemann does not expect a total cure simply from the anti-psoric internal remedies alone, for he precedes everything else by detailed regulations of behaviour and advice on the manner of life and dietetics, necessary during the anti-psoric treatment.  As  on  previous occasions  he again  forbids the enjoyment of coffee and China tea.  His  advice touches upon every  relevant  detail. Temperamental  influences  caused  by  trouble, need  and such like, or disturbances  of  the mind and  qualms of conscience  are  just  as harmful during anti-psoric treatment as mistakes in eating and drinking :

An innocent man  can spend ten years in the Bastille  or in the galleys suffering bodily torment with less prejudice to his health than a few months, with every bodily comfort, spent in an unhappy marriage or with a gnawing conscience.  .   .  .  With what difficulty and how rarely can  in  that case  the best anti-psoric cure accomplish anything for the good of the unfortunate ! With continuous grief  or worry, with  the unending  presence of trouble and vexation—greatest of all destructive  agents to life—no success can be hoped for in the chronically diseased, even with a most masterful guidance in the cure or with  the most carefully selected,  the most suitable remedies. For  continuation  of the finest  structure  is foohsh if the foundation of the building  is  being  daily—though  it be  only  gradually—undermined by lapping waves.”In place of warm and hot cleansing baths, which never cease to disturb the condition of the invalid, those infected with a Chronic malady must restrict  themselves  during the  anti-psoric  treatment  to ” tepidly  cool ablutions ” with soapy water, whereby  the purpose is completely achieved without any injurious effect.”

“Anti-psoric remedies (86) are selected according to  the usual general principles  of homoeopathy and  administered  one dose at a time, the effect of which is as a rule allowed to pass away completely before being repeated. Often this is only the case after 24, 30 and frequently as much as 40 and 50 days.  The fundamental rule is : To allow the dose of the medicine, which has been carefully selected for its  homoeopathic suitability  according to the  symptoms of the particular  case of disease, to have  its effect without  interruption as long  as it is visibly  helping  on  the  cure and increasing  to  an appreciable extent the improvement of  the malady. Slight  ailments  and additional symptoms such as headache,  stiff neck,slight diarrhoea, etc., which may occur during an anti-psoric cure,  should not induce a patient to have instant recourse  to other medicines,  as the effect of the anti-psoric may easily be thereby disturbed and opposed.  Such symptoms are very often only  the consequence of the remedy acting homoeopathic aggravation of moderate extent, a sign of the cure beginning which one may hope with tolerable certainty to see achieved.”

Should, however, very obnoxious symptoms make their  appearance, an antidote is given, under the assumption that the anti-psoric remedy was ill-chosen.   Thereupon the complications generally disappear quite rapidly. Over hasty repetition of anti-psoric  remedies is to be avoided as much as the employment of too large doses.  As is well known, Hahnemann soon deserted this principle and allowed his  chronic patients to use the suitable remedy  more  frequently—even  daily—changing  constantly the  degree of dilution from higher  to  lower and  lower potencies.  (Vide ” Organon,”6th Edition, S 246.)

“But if the invalid incurs during the anti-psoric treatment an acute illness like measles,  scarlet fever, influenza,  pneumonia, etc., the treatment of the chronic disease must be interrupted.   The anti-psoric treatment may only be continued again after the acute illness has been cured with the help of the suitable homoeopathic remedy.The best time for taking a dose of anti-psoric medicine is before breakfast. Female patients must stop taking the medicine shortly before menstruation and during that period.  Pregnancy, however, is no hindrance to anti-psoric treatment.  On the contrary,  ” in this condition, so natural to  a woman, the symptoms of internal psora often reveal themselves most clearly because of the increased sensibility and sensitiveness of the woman’s body and mind :anti-psoric  medicines therefore have a more definite and appreciable effect.”

In revising the ” Organon,” 1842, Hahnemann refers in a footnote to

  • 284 with repeated emphasis to the merit of anti-psoric treatment  during pregnancy and suckling, because, hereditary  transmission of chronic diseases to the foetus and the suckling  can be  thus  avoided.

In  the ” ChronicDiseases ” he recommends :

“Medicine should never be given  to the  sucklings themselves.The mother or the nurse takes the  medicine  and through her milk it takes very rapid effect on the child with  a mild and powerfully curative value.”

The first volume concludes with detailed instructions for the preparation of homoeopathic  remedies  and so  the whole volume is devoted  to the presentation of his new theory of chronic diseases.

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