DEFECTIVE ILLNESSES – PIERRE SCHMIDT

 

This is how I translate the expression ‘Einseitige Krankheiten,’ which we find interpreted in the other translations of the Organon into French, as “partial illnesses,” which of course, is a mistake. This is what HAHNEMANN says in Paragraph 172: “A similar difficulty in the way of the cure occurs from the symptoms of the disease being too few – a circumstance 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 homœopathic medicines is still incomplete) are removed”.

In Paragraph 162 HAHNEMANN had spoken of fragmentary remedies that have not been sufficiently tried which he calls: “Unvolkommene Arzneikrankheits-potenz”.

In the next edition of the Organon it will be a good idea to complete the expression ‘defective illnesses’ and say, rather, ‘natural defective illnesses’, in contrast to these pathogenesis which have not been sufficiently developed.

Illnesses which show only one side, or one aspect, of their reality are called ‘Einseitige Krankheiten’. We are not talking here about partial or fragmentary illnesses, because they are illnesses which involve and represent all of the individual; but we mean that they do not show themselves completely. That is why I have called them defective illnesses. On the other hand, “Unvolkommene Arzneikrankheits-potenz” means ‘incomplete pathogenetic dynamisation’, which is a fragmentary drug that has not completely developed its action for want of sufficient proving, or for want of provers sensitive enough to react in all their faculties and organs: It isn’t the fault of the drug, but of circumstances which have not allowed it to develop all its potential richness.

Paragraph 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.”

Paragraph 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.”

The local illnesses, or the local maladies, which HAHNEMANN speaks about here, are in fact localized illnesses: The only local illnesses that we recognize in Homœopathy are the result of traumatisms. An eruption, a keratitis, an appendicitis, etc., are localized affections and not local. Among these localized maladies there are, for instance, warts, discolourations, intertrigo, strabismus, or squinting, aphthae, haemorrhoids, alopecia, etc.

We have therefore to consider three kinds of ‘defective illnesses’:

  1. Illnesses defective because of the patient: Because there is a lack of real symptoms expressed by the patient. The patient tells you what is wrong with him: I can’t sleep, I have no appetite, I feel tired. What can you do with symptoms like those? Nothing at all, because they are far too vague.
  2. Illnesses defective because of the doctor: They are defective because of the lack of symptoms discovered and collected by the practicing homœopath. In this case we must consider different insufficiencies:

a. Insufficient questioning: The doctor doesn’t know the modalities and concomitants that he has to look for while questioning the patient.
b. Ignorance of the four principles of questioning the patient:
i. the doctor keeps interrupting his patient.
ii. the doctor asks direct questions to the patient which can only be answered by ‘yes’ or ‘no’.
iii. the doctor asks questions grouped under two alternatives, obliging the patient to choose one of them.
iv. the doctor doesn’t know really how to ‘direct’ the questioning!
c. Finally, there is the doctor who is too hurried. The patient has no time to answer because the doctor keeps asking questions too quickly; or else, if the patient is rather talkative, the doctor stops listening to him; or else he can’t get an answer from a timid or an intimidated patient who does not dare to answer, or is too shy to answer. One mu st know how to encourage the patient to say everything that he wants to say. This is when we should repeat many times: Isn’t there anything else? And what else? Haven’t you forgotten anything? One must push the patient into a corner until he has nothing left to say at all. Only then can you start questioning him. Or, if it is taking too long, you can say to him: “That is very important. We will come back to that at a later date”. After five or six consultations like that your patient will have exhausted everything he has to say.
But I insist that you take the trouble, before starting to question the patient, to ask him whether he is sure he has told you everything. If not, at the end of your consultation, you may see him pull a little paper out of his pocket and start reading it. Then the whole thing has to start again. If not, he may say to you (with what cheek): “Doctor, you have no time to listen to me, and I couldn’t tell you everything!”
d. Then there is the doctor who interprets symptoms in his own way to simplify, or to save time, because he is in a hurry, leaving aside subjective symptoms and paying attention only to objective or immediately verifiable symptoms.

  1. Finally we have illnesses which are defective by their symptoms. These are illnesses which do not show themselves.

HAHNEMANN adds:

Paragraph 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.”

Paragraph 176: “There are, however, still a few diseases, which, after the most careful initial examination (paragraphs 84-98), present but one or two severe, violent symptoms, while all the others are but indistinctly perceptible.”

In this connection we must here remember the famous sixth paragraph of the Organon about the six categories you have to think about. Every homœopath must know these six categories, which the doctor must constantly have in his mind.

Paragraph 6: “The unprejudiced observer – well aware of the futility of transcendental speculations which can receive no confirmation from experience – be his powers of penetration ever so great, takes note of nothing in every individual disease, except the changes in the health of the body and of the mind (morbid phenomena, accidents, symptoms) which can be perceived externally by means of the senses; that is to say, he notices only the deviations from the former healthy state of the now diseased individual, which are felt by the patient himself, remarked by those around him, and observed by the physician. All these perceptible signs represent the disease in its whole extent, that is, together they form the true and only conceivable portrait of the disease.”

And then HAHNEMANN expounds these six categories:

  1. First of all, there are those which come up during the questioning and are told by the patient himself. One must therefore listen to what he says (or read what he writes) about his personal feelings and let him take as long as he likes. I insist on this. One must corner him completely until he has said everything he has to say.
  2. Symptoms obtained and listed by questioning people around the patient. There are things that the patient doesn’t say and which the doctor quite often doesn’t see but that the people around the patient know; for instance, night convulsions or other manifestations that take place during sleep, little faults of character, signs in the gait, certain attitudes, etc.
  3. Symptoms observed and noted by the doctor, with all the possible means at his disposal including x-rays, laboratory tests, physical examinations, and so on.
    After his first symptom triad, HAHNEMANN gives us a second. Here again the first translation we have is wrong. The first translation of the Organon, in fact, tells us something which we have never understood, that is, that one recognizes illnesses in three manifestations: signs, accidents, and symptoms. I racked my brains for a long time trying to find out just what these three things meant. This, in fact, is what they mean.
  4. Subjective symptoms felt by the patient himself, symptom often not objectively verifiable and very often minimized or neglected by the treating doctor. Homœopathy is always interested in subjective symptoms because it is interested in the patient, in his personal reactions, in everything concerning him; while ordinary medicine is interested in objective symptoms, in the illness, to make a diagnosis, for which a treatment will subsequently be prescribed.
  5. The signs are objective symptoms that can be measured, auscultated, felt, verified, identified, seen, and perceived, by all the means at our disposal either by our senses, or by the microscope, or all the apparatus used to detect symptoms or all the means known to the laboratory.

That is why, for us the homœopaths, there are no illnesses without symptoms, because any illness which doesn’t reveal itself to us through manifest symptoms can be discovered by laboratory techniques.

And the same thing applies, for accidents: The more blood there is, the more horrible it is and most of the time the less serious it is! But when we see just a small drop of blood coming from the ear or the nose, we know that it is much worse than something else which horrifies everybody around us. The small symptoms are always more important than the big ones. And in fact, it is the same in opthalmo-diagnosis. It isn’t the big spots on the eye which are important but the very small details, sometimes hardly perceptible.

  1. Accidents, unexpected symptoms, casual or accidental symptoms, all of them are symptoms occurring from accidents: burns, insect bites, wounds, etc.

We see, in addition, that ‘defective illnesses’ can present us with different possibilities:

  1. There aren’t enough symptoms, or not enough that can be considered usable.
  2. There are too many symptoms. When you have a big muddle of symptoms, what can you do? I remember having questioned a patient when I was studying with Dr. GLADWIN of Philadelphia. After questioning the patient for half an hour, which I thought was very thorough of me, and for which I even expected some congratulations. I had 40 symptoms, for which I had sweated… in English! She rejected them, one after the other, not one of them being of any use… I was really mortified. “You cannot”, she said (for this was a female doctor, if you don’t mind), “prescribe in any rational way on these symptoms because they are all common, too frequent, too vague, or too general: tiredness, depression, insomnia, headaches, constipation, diarrhoea, without any modalities at all”.
    The patient may also make things up that didn’t happen, and he gives you symptoms that you cannot make head or tail of, things that change each time. Still, we see very few patients who tell fibs or totally invent what they tell us!
  3. There is also the question of symptoms that the patient won’t tell you willingly because they are embarrassing, humiliating, shameful symptoms. You will find a remarkable description of these in the Organon, paragraph 93. It is up to the doctor to discover them with tact and psychology. I must tell you that opthalmo-diagnosis often helps us a great deal in this matter. I have often spoken about the flattening of the pupil at 12 o’clock: In the left eye it means sthenic manifestation, and in the right, asthenic, depressive. In the left eye it would indicate rage or repressed anger, for instance; in the right depression and sorrow.
    I have already told you the story of the young woman who had one of the highest positions on the O.M.S. She was divorced because she had married a fellow quite beneath her, a sort of moron. After that she met a diplomat from Paris who courted her and promised to marry her. They were to marry at Christmas. She was very happy to have found, at last, someone worthy of her. And a few days before Christmas the suitor called her on the telephone and said that he unfortunately couldn’t come, he had to leave, and wouldn’t be there for the wedding! She never heard from him again.
    She came to see me, saying, “Doctor, I am heart broken!” I looked in her eyes. At the top, at 12 o’ clock, in the right eye there was absolutely no flattening. In the left there was an enormous flattening. So I said to her: “You are not heart broken at all. You feel enraged about your self-esteem, with repressed anger,” Then she looked at me with tearful eyes and smiled, and said: “Yes, Doctor, I rather think you may be right!” And, of course, this was a case of Staphysagria not at all Pulsatilla or Ignatia. So the examination of the eyes will allow you to discover mental symptoms that you cannot find in any other way. We can also find very useful symptoms which the patients do not tell us without asking a single question, by observing the handwriting, the lines of the hand, the nails, the wrinkles of the face, the ears. THERAPEUTICS OF DEFECTIVE ILLNESS HAHNEMANN has the following to say about this: Paragraph 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 homœopathically indicated”. A little before that he says in paragraph 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”. This shows that most often it isn’t only the patient’s fault, but above all the doctor’s fault. It is up to us to know our Materia Medicasufficiently well, to know what we have to ask. I must say that the disciples of KENT have a great advantage. First, simply by opening KENT’s Repertory they have a whole list of questions they can ask, which is to their advantage. Secondly, they know that all these questions have corresponding answers in the Materia Medica, which is another advantage. When we know our way around our repertory, we have there a considerable spectrum which allows us to ask questions that a doctor without a repertory cannot know, and therefore cannot ask, simply by relying on his memory. This is an enormous advantage over all other practitioners. Paragraph 178: “It will, no doubt, sometimes happen that this medicine, selected in strict observance of the homœopathic law, furnishes the similar artificial disease suited for the annihilation of the malady present. This is much more likely to happen when these few morbid symptoms are very striking, decided, uncommon, and peculiarly distinctive (characteristic).” Paragraph 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 a small number of symptoms to guide to an accurate selection”. Now we come to the question of the so-called accessory symptoms, about which HAHNEMANN writes, as follows: Paragraph 180: “In this case the medicine, which has been chosen as well as possible, but which, for the reason above stated, is only imperfectly homœopathic, will, in its action upon the disease that is only partially analogous to it – just as in the case mentioned above (Paragraph 162, et. seq.), where the limited number of homœopathic 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.” You see, HAHNEMANN thought of everything. These are revealing symptoms, which were hidden and now are laid bare. So you see that the expression ‘partial illness’ was not accurate. These new symptoms can perhaps be linked to the secondary symptoms, or the iatrogenic symptoms of our allopathic colleagues, who are always striking the edge of toxicity with all their new drugs. After all, we must remember that allopathy is interested in finding out just how much of a drug the patient will tolerate: whereas we, the homœopaths, deal in the minimum effective dose! Paragraph 181: “Let us not object that the accessory phenomena and the new symptoms of this disease that now appear should be laid to the account of the medicament just employed. They owe their origin to it [1] 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”. Paragraph 182: “Thus the imperfect selection of the medicament, which was in this case almost inevitable owing to the too limited number of 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, homœopathic medicine”. Paragraph 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 homœopathic 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 homœopathic 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. [2] This is something which KENT often repeats. You have given a remedy and the result isn’t brilliant. Instead of starting immediately to give a whole lot of other drugs, question your patient again, complete your examination, and you will see that quite often the remedy will manifest itself without any difficulty. In addition, this paragraph raises the question of lack of reaction, if we have proceeded as we should … Here it is well to remember that we must differentiate between two categories of reactions: The drug has been really well chosen, based on a serious case-taking. Its origin and preparation leave no doubt about its effectiveness; it corresponds to the patient’s real symptoms of the moment. In this case HAHNEMANN indicates Opium, if there is a lack of reactions. You know that Opium paralyzes, stops all reactions, whether nervous, muscular, or sphincteroid. That is why, according to Dr. FLURY, when a doctor is called to a case of hepatic or renal colic at night and makes an injection of morphine, he always goes home disgusted, annoyed, and dissatisfied with himself; but, if he has been able to find the right remedy and relieve the patient – and this is perfectly possible – then it is quite a different story and he has a clear conscience. In KENT’s Repertory on page 1397 there is the rubric; ‘Lack of Reaction”, you will look back to page 1369: “Lack of Irritability’, and you will add to the rubric on page 1397: Bryonia, Calc-iod., Cypripedium, Tub., X-ray, Zinc. And when too many drugs have produced a state of hypersensitivity and the remedy fails, you have to think of Ph-ac., and above all Teucr. (page 1369 ). On page 1288, in intermittent fever that has been spoiled by a whole lot of drugs, you have a rubric which indicates several drugs, among which you find Sepia, and you find it listed equally on page 1282. Now we come to a whole series of precisions, very useful in practice, which allow us to choose the reactive remedy properly. These reactive remedies will either open up the case, bring about an initial improvement that can be followed up later on, or else, more often, they will not seem to produce any immediate result; but afterwards the patient will feel an indefinable improvement in himself, and a repetition of the drug, which started the improvement in the beginning, and then seemed to stop acting will bring about a new improvement and sustain that improvement. Thus the flame will be rekindled, and the favorable reaction, which was interrupted, will be revived and strengthened once again. Therefore we shouldn’t believe, or expect, that the reactive remedy will bring about an immediate result. Sometimes there will not be any apparent result, but the real remedy of the patient will once again be able to act. A general rule is not to repeat the reactive remedy. We give it only once and see what happens, or, as the English say: Watch and wait. After the reactive remedy how long should one wait? Usually three to five days, or even longer, if there is a good result (and in that case continue as usual allowing the improvement to run its course). But, if you have no result, wait three to five days without repeating the original drug.
    REACTIVE REMEDIES OF THE AGED In KENT’s Repertory look under ‘Old People’ or ‘Aged People’ or ‘Old Age’. An elderly person is someone who is at least over 65, although certain patients are old long before that, and, on the other hand, others who have reached 75, are still very young. Therefore this is a question of discrimination which you will have to make for yourself. There are two excellent reactive remedies for elderly persons: Ambra grisea and Teucrium marum verum, which you will give if you have some symptoms indicating them, and I shall speak about that now. Ambra grisea: Is suitable especially for elderly people and patients who are weakened by age, or as a result of over-work. These people are hypersensitive, exhausted, nearly always have insomnia because of worry, and have to get up at night . Usually there is aggravation from music, which they do not like and which makes them weep. Crotchety and fussy, they hate anything which is out of the ordinary routine of their lives and disturbs their habits. Like Cann-i. andGlon., for them time passes too slowly (if it passes too quickly, Cocc.). They are nervous, intensely shy, and cannot do anything in the presence of someone else. They desire to be alone. Nervous and excitable infants; loquacious subjects; a great remedy for elderly people disgusted with life; people hating strangers and everything new. These patients usually suffer on one side only, usually the right side, but also the right side on top and the left side at the bottom. When certain subjects have symptoms only on one side, and you cannot find those symptoms listed on page 1400 of theRepertory, under the right or the left side, whichever the case may be, then you should look at the first rubric, ‘Symptoms on One Side only’, without worrying about whether it is the right or the left side. Ambra symptoms further include:
    Vertigo of the aged and loss of hair.
    Epistaxis, aggravated in the morning; much bleeding of the gums.
    Frequent feeling of coldness on the abdomen.
    Spasmodic cough with eructation; aggravated in the presence of others;
    A loose, deep hacking cough with palpitations;
    Nymphomania;
    Pruritis of the sexual organs;
    Tendency to metrorrhagia;
    Cramps in the hands and in the fingers.
    Teucrium marum verum: When the great number of drugs administered has produced a state of hypersensitivity, with the result that no remedy, even if it is indicated, acts. Specific action on the nose and the rectum. Generally speaking patients who needTeucrium usually have:
    Dry, chapped skin and have suffered in their infancy (or still suffer) from mucous polyps somewhere in the nose or the nasopharynx, or the womb, or the bladder, or the rectum.
    Childhood complaints.
    A nose that is always stuffy.
    Ozæna.
    Anosmia.
    Coryza with blocked nose.
    One of the remedies that have the sensation of ‘internal trembling’
    These patients are prone to hiccups and nearly always have the post-nasal passage blocked.
    Constant hiccough while eating or after lactation.
    Musty taste in the mouth. REACTIVE REMEDIES OF CARDIOPULMONARY PATIENTS In this section there are five remedies which are especially important . First of all: Carbo vegetabilis: This remedy is a classic for subjects who have never recovered their health after a serious illness (pneumonia, typhoid, grippe, etc.). This is one of those cleansing remedies, a great ‘drainer’! In that case give 10M potency, which works particularly well. A reactive remedy for defective reactions. It is also indicated after strong allopathic ‘drugging’. Remember that in the Carbo veg. patient everything is cold: the end of the nose; the extremities, hands and feet, face, teeth, mouth, breath, integuments – not only cold, even icy, except for the head, which is often hot. In spite of this typical cold, with venostasis, cyanosis, these patients quite paradoxically often have: Feelings of local and regional burning. Carbo veg. is anxious, especially in the evenings, in bed, on closing the eyes. He presents three very different, but very characteristic states: discouragement; indifference to everything, without reaction; irritability. Generally speaking, collapse and all kinds of fainting following the loss of vital fluids. Stagnation of blood in the capillaries, causing simple ecchymoses, cyanosis, haemorrhage of all the mucous membranes. Septicaemia.
    Asthenia, exhaustion, debility; easy fainting, for instance, in the morning upon getting up.
    Aggravated by fatty food, butter, pork, rich food.
    Heavy head, as if squeezed; hat feels too heavy.
    Hot head, breath cold.
    Hair falls out easily.
    Black “muscae volante” before the eyes.
    Dry ears, or ears with too much wax.
    Epistaxis every day; black blood.
    Cyanosis of the face; chlorotic; pale, pasty; unhealthy look.
    Hippocratic facies.
    Cold sweat of the face, mottled cheeks, and the tip of the nose red.
    Cracked lips; gums that bleed easily, especially when they are sucked.
    Amelioration from eructation of wind, especially after butter and acids.
    Stomach cramps which fold the patient in half, half an hour after eating, aggravated in summer.
    Stomach burning and morning nausea.
    Desire for salty things.
    Aggravation from all fatty food.
    Frequent indigestion; very sensitive epigastrium.
    Painful diarrhoea of elderly people.
    Glutinous secretions at the anus which burn, aggravated by scratching.
    Green leucorrhea; early menses; prolonged menses.
    Excellent remedy at the beginning of whooping cough.
    Wheezing respiration.
    Carbo veg. nearly always feels weight on the chest; constantly oppressed; frequent need to fan himself; needs the windows wide open; he needs air so badly that he asks for something with which to fan himself.
    Sighing and irregular breathing.
    Faint, feeble, imperceptible pulse.
    Hoarse voice, no pain, aggravated in the evening.
    Weak voice, especially singing high notes, aphonia.
    Coryza with cough.
    Cold hands, knees, legs, worse at night.
    Prunus laurocerasus: For cardiovascular complaints with cyanosis and dyspnoea. Cyanosis and rales in the newborn.
    The cold is not ameliorated by heat, he always has his hand on his heart.
    This is the typical snorer, with very deep sleep (catapnoea). As far as the snoring is concerned, and the stertorous respiration, this remedy rivals Opium and Lac caninum, which are the two remedies which have the most snoring (or the best). This reminds me of a story of my dear mother, who was still very active at 82 when she returned here in March from a trip to Cannes. Eight days later I went to see her one morning and rang her doorbell. No reply. Fortunately, I had a key. I went in, saw the kitchen, the sitting room, empty. No mother! Where could she be? That was when I heard a dreadful snoring. I went into her room and found her in bed, eyes closed, absolutely passed out, with the rale of the dying. Alas, I know that rale very well. Speaking of this, I must tell you that this is something that always worries people around the sick. I saw that in my Master, who was dying when I was in India. Many nervous and agitated adepts were around me and begged me to do something to calm him down, give him a shot of morphine – which he would never have allowed. I simply turned his head a little to one side, and the rale immediately stopped. Therefore it was enough simply to modify a little the position of the head! For people who snore when they sleep at night it is quite a different story. Often they have an elongation of the uvula, and when they lie down, especially if they lie very low, the uvula vibrates in the back of the throat. This disturbs many people, especially the wife, who is furious because she can’t sleep; whereas her husband sleeps with his fists closed, snoring! There are special little structures which one can fix on the neck and the head, and which hold the chin and do not allow it to drop; but husbands do not readily accept this imposition, as you can imagine. Yet, I once knew a great lawyer at the International Court at the Hague, a director and president of many commissions and congresses; but he was like a little boy before his wife. She made him wear this sort of mask, which stopped his chin from falling when he slept. The poor man hated it but he had to take it! This method is usually not very popular. Snorers can use an extra cushion behind their backs so that the whole thorax is higher and the airway functions without obstruction. One can also wear a belt with a big knot in the back which will force one to sleep on one’s side, and this lessens the condition. Well, I found my poor mother in this state. I lifted the blankets and looked for reflexes, there were none in any part of the body. I lifted her arm, it fell back heavily. I took a pin and tested her sensitivity by pricking her more or less deeply, evoking no movement at all. The pupils were very small and hardly reacted to light. What was I to do? I thought that at 80 one had the right to die in peace; so I called a nurse to look after her; and there was nothing for the nurse to do. Three days later my 19 year old niece, who studies biology and works in a laboratory, said to me: “Really, you homœopaths make me sick! Half of your remedies are only make-believe! That is why you leave your patients to die with their arms crossed on their chests. Do something, an injection of strychnine or camphor or anything at all, but do something!” We had a dreadful argument, but I thought that perhaps there was something in Homœopathy that one could give. When you see someone who doesn’t move and has no reflexes, with a very small pupil, and who snores, and is completely unconscious, what picture does that bring to mind? Well, you must be an infant in arms not to think of Opium. So I gave my mother a 200th potency of Opium, just a few tiny globules on the tongue. Ten minutes later I saw her left eye open and close and her right eye do the same thing. Half an hour later her eyelids started fluttering, then movements appeared in the upper limbs. The first night she urinated, and the intestines rendered unto Caesar that which was Caesar’s. In a word, in the evening she had reflexes and her pupils had become larger. I gave her three doses in all and the result was extraordinary and spectacular. Eight days later she was sitting up, spoke a little, although with difficulty. And a month later, would you believe it, she was gathering flowers on the Petit Salève Mountain! She lived three years after that. I wonder what our dear colleagues would have done? No doubt, injections of Camphor, or Coramine, or God knows what else; and certainly they wouldn’t have any result except to send her off from Charybdis to Scylla. Hydrocyanic acid: A great cardiovascular drug, which is often forgotten; and yet it has always given me remarkable results. It is one of the most toxic and most mortal poisons!
    For the mental symptoms, it is an interesting drug. It is a great frightener, fear of everything.
    It also has cyanosis, with collapse, but more pulmonary than cardiac; while Carbo veg. and Laurocerasus have more effect on the heart.
    Suffocation and constriction of the chest.
    Palpitations.
    Angina pectoris
    The pulse is slow and flabby.
    Sensation of emptiness, epigastric region.
    Foaming at the mouth.
    You always have to look at the pupil; the pupil of Hydrocyanic acid is dilated and without reaction. Ammonium carbonicum: These patients don’t like cleanliness at all. You may be sure that they use neither brush nor soap. They hate water and hate using it. This doesn’t mean that you will give this remedy only to patients who are dirty. This remedy presents an absolute incompatibility with Lachesis, and you have to know this incompatibility. You can have serious accidents if you give Lachesis after Ammonium carb., in the hope of getting a reaction… just try it! This patient is usually sedentary. Big people, always tired, exhausted for no reason at all, with heaviness of all the organs.
    Hates cold air. Doesn’t even like to touch water, let alone cold water ! Sulphur doesn’t like to be washed.
    Ammonium carb. doesn’t like it either but he actually fears the contact with water, which he hates. Always has to carry a bottle of smelling salts to avoid fainting, or swooning!
    Epistaxis after washing the face or the hands, and after eating; especially at night.
    Marked tendency to catch cold.
    Nose always blocked. The nose is especially blocked at night.
    Lips cracked; cracks in the corners of the mouth; a crack in the middle of the lower lip. Wakes up every morning sneezing. I have a patient who said: “My husband is unbelievable! I always know what time it is because at exactly seven o’clock in the morning suddenly I hear him sneeze. He wakes me up!” One dose of Ammonium carb. (and you will find that it is in the third degree in the Repertory) succeeds in most instances.
    Creaking of the jawbone in chewing.
    Bleeding haemorrhoids, aggravated during menses.
    Anal pruritis.
    Protruding haemorrhoids during stool.
    Very frequent menses, profuse, with great tiredness.
    Pungent, abundant, burning leucorrhoea, milky and smelling of ammonia.
    Aversion to the opposite sex.
    Involuntary urination at night.
    A feeling of fullness in the head.
    Patients who are rather obese, with a large appetite.
    Audible palpitations; they say that they can hear their heart beating! Angina pectoris. This subject is rather chesty, asthmatic, always out of breath, with noisy breathing that is more or less audible. Great remedy of emphysema. The oppression is noticed particularly in climbing, but also on entering a hot room. All chest symptoms are always aggravated at three o’clock in the morning.
    All the pains are ameliorated by external pressure.
    Whitlow.
    Heaviness of all the internal organs.
    It is a remedy for uremia, don’t forget this. It antidotes adrenalin. Tarentula hispanica: This drug is very much neglected, and it is a pity: First of all, it is one of the most agitated of the drugs. He can’t sit still, he can’t stay in one place, must move about, especially at night. Syndrome of the legs that will not rest, constantly fidgeting. You must remember also that this fidgeting is both physical and mental. The agitation is often anxious. Aversion to company, but patients who respond to Tarentula always want someone near to them, ready to help them. Always dissatisfied.
    Capricious. Very changeable moods. These people are difficult to live with, whether children or adults. Precordial anguish with constriction.
    Palpitations with the feeling that the heart is being squeezed.
    Immediate amelioration from music! That is why in my consulting rooms I have a button I can press to switch on a recording of music. When I have restless children, who run all over the room, I press the button, and as if by a miracle they stop, calm down, and listen! This is a very good indication for Tarentula. Yearly periodicity. REACTIVE REMEDIES FOR NERVOUS SUBJECTS Gelsemium sempervirens: You know that in English you can sum up this remedy with three ‘D’s’:
    Dizzy,
    Drowsy,
    Dull.
    When you see somebody, especially after flu, who is dizzy, and always drowsy, no thirst, apathetic, dull, think of this remedy. Gelsemium has always light-colored urine, never dark, even when there is fever. And if you prescribe Gelsemium for a patient who has dark urine, that will prove that you are extremely defective and have a great need to take a refresher course! Frequent urination, abundant urination which relieves headache. A great remedy for trembling, but I draw your attention to this: external trembling. One can say that many Gelsemium patients, especially feverish patients, complain that everything is trembling.
    The pulse is abnormal, slow but full, intermittent, irregular. It can also be rapid and tachycardic, feeble, soft, almost imperceptible, aggravated by movement. It is these apparent contradictions that make the charm and the value of our Materia Medica. You know that this is the remedy for bad news, and you remember the story [3] of the patient I spoke about before who was overtaken with a dreadful buzzing of the ears when he received a bad news, the sudden death of one of his friends, whom he had recently seen. And he was brilliantly cured with this remedy, while our allopathic colleagues had energetically treated him without the slightest little result… quite the contrary! Every time a patient tells you that he has had a sudden sorrow, ask him how it started. Often it comes from the shock of some bad news. In such cases always prescribe a high potency: Gelsemium 10M. If, on the other hand, this is a case of real sorrow, rather give Ignatia; and speaking of that, I have had cases which came back and reproached me afterwards: “Doctor, it is quite dreadful, you gave me a homœopathic remedy so that I would be sustained under the emotion of a great bereavement; I went to the funeral and, although I am so sensitive, I couldn’t even cry!” Aggravated by all emotions. A great fearful remedy. Always a terrible fear before examinations. This is very successful when it is prescribed as a specific for fear of examinations. I give a dose of the 200th the morning of the examination, and if this fear of the examination is very pronounced, a dose even the day before in the evening. More often than not that is admirably successful; I don’t even have to repeat it afterwards. What an advantage and what a blessing, especially in pipe organ examinations, when one’s foot trembles on the great bass pedals… to make even the examiner tremble; and as for singing… when you can’t get a sound out, Gelsemium maintains the voice of a nightingale! So Gelsemium is very apprehensive. Very frightened especially frightened of death. Remarkable after fear and emotions.
    Wants to be left in peace.
    Agoraphobia, fear of walking across large open spaces.
    Fear of being alone, wants someone near, even someone who doesn’t speak. Fear of going in mountain cableways and elevators, even going down! Terrified of everything unexpected. Fear of falling. Fear of losing his self-control and his calmness.
    Fear of lightning; what a dreadful coward! A real living barometer. Gelsemium very quickly feels all the fluctuations of the weather, especially when the barometer falls. Constantly aggravated by thinking of his troubles. But be careful, he unfortunately always feels better when he has had alcohol to drink! I had a patient once who had this unfortunate peculiarity with, in addition, all the other symptoms of Gelsemium. She used to say to me: “Doctor, you wouldn’t believe it, a friend of mine told me about this: I take the tiniest possible glass of ‘kirsch’ every morning, and afterwards it is absolutely marvelous, I feel that I have wings all day long to do the house work”. That is really dangerous. She started with a tiny little glass, and a year later it was a litre of ‘kirsch’ that she drank every morning. Her liver, especially, suffered from this, as you can well imagine. She developed dropsy with a whole lot of complications and she died of anasarca in the greatest moral and material misery! The constant repetition of her vice immediately antidoted the action of Gelsemium! Fear of death. Feeble, slow pulse, even imperceptible. Capsicum annuum: This drug is not chilly, as you will see it stated in many Materia Medicas, but on the other hand is aggravated by the cold and the slightest draft, which is an important nuance you have to remember. Capsicum patients are flabby, obese, lazy; they want to be left in peace; these patients are apathetic and are always down. I promise you that you will never find them breaking speed limits. Lack of reaction in obese patients. These people love routine and they hate anything unexpected. Write it in your repertory under the heading ‘Unexpected, Aversion to Anything’. If you tell them that you will take them on a drive tomorrow, they won’t like that at all. You will have to tell them long in advance. Great difficulty getting going to go out or to go on a drive or a walk. They hate all exercise and all effort. And yet, amelioration once they start to walk. Capsicum is an overworked intellectual who doesn’t eat enough and is always in need of stimulants and tonics. Dyspepsia of elderly people. It is a funny thing that this patient is always thirsty after stool!! And his scrotum is cold in the morning on waking up! Like Ammonium carbonicum this remedy isn’t very fond of cleanliness; you will see that their clothes are dirty, their ties have spots on them, and they are always improperly washed or shaven! ugh! Constantly dissatisfied and complaining. This drug is indicated for a special illness, for which Allopathy is absolutely useless unless you go through two years of psycho-analysis… It is homesickness. This drug is especially recommended for young maidservants who have bright cheeks and who suddenly tell you after two weeks of their new job that they cannot stay and want to go home… A little dose of Capsicum 10M on the tongue of the young girl will bring back a smile and the pleasure of serving you! The Germans make fun of these symptoms and say: “These homœopaths are quacks… they prescribe Capsicum for red cheeks and homesickness… It seems quite ridiculous…” But since it works I am very happy to use this remedy when it is indicated in this way, and I would very much like to know what an orthodox physician would do in such a case. You can’t get anywhere, and the young maidservant goes home. Everything is overthrown for her and for everybody else! So this is a great remedy in cases of homesickness. Hates drafts. Explosive cough, as if everything were going to explode: head, ears, bladder, chest. Sciatica aggravated from coughing. Hoarse, raucous voice of public speakers, ministers, and singers.
    There is a localization for which this remedy is very successful: the mastoid. One or two doses of the 200th potency, and the threatening mastoiditis disappears rapidly. This remedy acts very quickly and very well. Smokers and drinkers who suffer from sore throat and pains that go to the ears, with fetid breath. Valeriana officinalis: When it is dynamised, this plant has an affinity with subjects who have an extremely variable temperament. The height of instability. I don’t mean alternating moods; I mean variable and irritable moods. Impressionable, hypersensitive, very nervous.
    Asthenic. Hysterical complaints.
    Pulse generally accelerated.
    Nervous system always rather excited.
    This remedy has the sensation as if there were a thread hanging in the throat!
    Excellent drug for babies who vomit great pieces of curdled milk after feeding. Calcarea ostrearum: We must not use Calcarea carbonica which is indicated in all the books and is a chemical carbonate of lime, but, if we are serious homœopaths, the living calcium, which is called Calcarea ostrearum, and is made by the oyster in the middle layer of his shell. If we want to go one step further in subtlety, we always use only those remedies which have been prepared from sources which were used for the provings. But Providence is so generous that even if we practice Homœopathy ‘badly’, even if we haven’t got ‘perfect’ remedies we can still achieve extraordinary results. Really, our needs have been abundantly filled, and we should be grateful. Calcarea ostrearum is the great homœopsoric of HAHNEMANN. It covers all three miasms, and Calcarea is a remedy which we cannot do without. It is a part of the cycle Sulphur-Calcarea-Lycopodium, and therefore should never be given after Lycopodium nor before Sulphur. That would mix up the case to such a degree that it would be very difficult later on to clear it up. KENT said that there were certain patients who could never be restored because this rule had not been observed in their case. In the same way one should never go directly from Sulphur to Lycopodium one must find an intermediary drug to give between the two. These little points of advice of old, seasoned homœopaths must really be respected! The leukophlegmatic type, who, to speak from a hormonal point of view, has a thyroid-pituitary dysfunction. Produces goiters… and cures them!
    Great remedy for very shy people. Has many fears, like Phosphorous. And my teachers taught me that when any case has more than three fears, one can almost always say that either Calcarea or Phosphorous is indicated. On condition, of course, that we are not speaking about a mental case, because it is very difficult in those cases to eliminate everything which can be pathognomonic. He is very much afraid of: illness and contagion, epidemics, falling ill, suffering, tuberculosis, heart disease, being observed. He is afraid of spirits, of losing his reason, disaster, losing his position, he is sure that a disaster will happen. He is afraid of: poverty, dying of hunger, obscurity, night, evenings, and above all, twilight. He is afraid of: being in bed, dogs, being in a crowd, animals, being alone, lightning and above all, death. He is horrified on hearing stories of cruelty. I have already told you the story of Dr. MATTOLI who was a man just as small as he was intelligent, a brilliant mind who spoke with great facility, and what volubility! – all this, of course, in magnificent Italian. One would have thought it was DANTE speaking: and when he was speaking, even if you didn’t understand Italian, it was a pleasure to listen to him. Well, Dr.MATTOLI was once president of a congress in Rome when Mussolini was in power. The first day we were all assembled in an extraordinary hall with flags of different colours, old paintings, sculptures, beautiful armchairs, and we heard the President of the Ligue, Dr. GAGLIARDI, presenting to us a case of mental illness which had been cured by Calcarea. His description was perfect: he made of this expose something so marvellous from a scientific and literary point of view, that from the sixth row, where there were some allopaths who had been invited to the congress, one suddenly heard someone exclaim, ‘Miracolo’! That’s how marvellous his description was! Then, suddenly like a devil jumping out of a basin of holy water, Dr MATTOLI got up and said: “Who says it was a miracle?” Then these colleagues of ours got up and nodded – I mean the allopaths we had invited! MATTOLI continued: “Well, gentlemen, I must say, you are the only ones who make miracles, not us”. And these gentlemen were very pleased, even more puffed up with pride, delighted with this compliment! MATTOLI continued: “Because, what is a miracle? A miracle is something exceptionally rare, which doesn’t happen often. But for us homœopaths, successes like this happen every day! And that is why we don’t call them miracles!!” Sustained applause throughout the hall ! You can imagine the effect of this interruption! Calcarea is full of many fears, there are 26 different ones in KENT’s Repertory! In addition, Calcarea is very forgetful. He also despairs of recovery (like some other drugs). Anxiety at dusk. Very much indicated in convalescence that are not getting on and for patients who continually relapse. Very willful infants with a tendency to obesity. There is a special sweating which is always regional, localized! – especially in the front of the body; and he perspires at night. He also sweats when he is anxious or after eating, or at the slightest exertion, or even from mental activity. Look at the pupils. Calcarea is often mydriastic like Belladona, its acute. Eyelids glued together in the morning. Tumultuous palpitations at night; after eating; with the slightest exertion, especially on climbing the stairs; also during fever. Aversion to movement and exercise—a very lazy schoolboy who will ask to be let off gym practice! He can’t stand fasting or skipping a meal. And yet, he always feels worse after eating! Isn’t it hard to reconcile these paradoxes! Diarrhoea and vomiting at teething. Desire for eggs, and particularly hard-boiled eggs. As a child he prefers and enjoys things that are rather strange and indigestible: chalk, carbon, pencil leads, etc. He loves sour fruit and, above all, ice cream. He hates fat and two more things: coffee and meat. That doesn’t mean that you must never give Calcarea to someone who likes coffee. There are other symptoms which will indicate it, and you can’t possibly expect to find all the symptoms that Calcarea will cause and cure! You know that classic symptom of Calcarea – horrible visions at the moment of falling asleep. He sees scowling faces! This symptom is very useful for prescription. Amelioration from constipation, which is a rare symptom but a precious one, and unless I am mistaken, a symptom which is to be found in only two other remedies besides Calcarea. Look for them in the Repertory and don’t forget them! Calcarea infants sometimes have enormous stool, and one wonders how it is possible for infants to expel such stools! When a patient who smokes suddenly loses his taste for cigars or cigarettes, think of Calcarea. This remedy loves good wine, liqueurs, cold drinks, but on the other hand prefers milk when it is very hot! He loves everything which is salty or sour. It is a very good remedy if, in addition to these general characteristics, the patient suffers from polyps or exostoses. REACTIVE REMEDIES OF ORGANIC COMPLAINTS For the sequelae of paralysis, apoplexy, exhaustion, all cerebrospinal affection, depressions, asthenia, there are three remedies we have to think of above all; Zincum, Conium, and Helleborus.
    Zincum metallicum: One word sums it up: exhausted (overworked, broken down). As the English put it, ‘fag’. This patient has no more vitality: he is completely prostrated, can’t go on: he is exhausted: he has capitulated! As soon as he becomes ill he is immediately depressed, immediately thinks of the worst. Zincum straight-away thinks of everything in the blackest terms! Spinal affections.
    There is an etiological symptom that you must know because it always succeeds very well and is very precious for us homœopaths, who usually have to treat the leftovers of Allopathy. We nearly always see cases which have been treated, manhandled, spoiled, complicated… and when we cure them we are told that this is imagination! When you have an eruption which has been suppressed, a discharge which has been stopped by nitrate of silver, by suppositories, or by ointment, etc.,Zincum is the king of all such situations. In those cases we see the discharge reappearing, the eruption flowering anew, and the patient feeling better. In a case of measles, scarlet fever, any eruptive fever, any eruptive illness which doesn’t end properly, give a dose of Zincum and immediately you see the eruption coming back. Remember that Zincum ameliorates every dischargewherever it is: excretions, urine, diarrhoea, suppurations, menses, etc… Every patient with trembling, tics, myoclonus, spasms. Syndrome of legs that cannot stop fidgeting. Agitation when seated; pupils who constantly move their legs during class!
    Hypersensitive to noise and above all the sound of voices, which put him beyond himself! The child repeats questions that are put to him and everything one says to him. Like Sulphur, he has a sudden ravenous hunger at 11 o’clock in the morning. If he goes home at about 11 o’clock he immediately looks for something to eat because he can’t wait for lunch… Zincum cannot stand wine. Cephalalgia from alcohol. The pulse is rapid, especially in the evening, and it is intermittent. This is an objective symptom which can be useful in defective illnesses. Very good action on pterygia; itching of the internal canthus, which is often irritated; rolls his eyes; looks cross-eyed. Pale complexion; angular cheilitis at the corners of the mouth; tendency to hawk. Children who constantly move their legs for fear of urinating, who lose their urine while walking or coughing or sneezing. The loss of pubic hair in both sexes. Pains of the left ovary; sensitive breasts, especially during menses; menses more abundant at night; complaints that are noticeably ameliorated during the menses. For those whose legs fidget during sleep; Itching of the thighs and especially of the popliteal spaces. It is a great remedy for varicose veins of the lower extremities which are aggravated during pregnancy; chilblains of the extremities; somnambulism. All the results of eruptions having been suppressed by ointments, lotions, radiations, all other external means. Conium maculatum: This is an old remedy which has become a classic, thanks to PLATO, because it was used to put SOCRATES to death. It is the remedy of bachelors and of old maidservants… the type that likes to be alone and hates visitors. He hates people he doesn’t know because he is shy. Hypochondriac, indifferent, not interested in anything; averse to all intellectual work and also to all physical effort. Weakness, decline, laziness. It is very difficult for him to come to the point of starting to do anything. He cannot walk quickly; he cannot hurry; and if you want to go with him you will have to proceed at his pace, which is always slow. He always feels better when he can let his arms or his legs hang! Here we have another one of those things that may seem useless and unimportant, and yet for an informed homœopath it will allow him to select the right remedy! Heavy, stiff legs; difficult walking. Neoplastic and arteriosclerotic diatheses. The head spins, often with headache, and always aggravated from lying down. A great characteristic of the dizziness of Coniumis the amelioration from closing the eyes.

Pronounced photophobia to all light, but without inflammation of the conjunctiva. Aversion to light without any affection of the eyes.

The cough is aggravated on lying down; and when he starts to cough at night in his bed, Conium must sit up. Coughing from irritation from a little dry point in the larynx, aggravated lying down; must sit up.

The pulse of Conium is accelerated after stool; it can also be small, intermittent, and irregular.

Interrupted urination. The urinary stream stops, then starts again!

Palpitation after every defecation.
The results of sexual repression in both sexes.

Sexual desire without erection.
Swelling of the breasts, with bruising pains, from touch, especially in front, but also during menses.
Perspiration as soon as he falls asleep, and even as soon as he closes his eyes. Excess of wax in the ears.

These patients feel better with the arms and the legs hanging.

Helleborus niger: This drug brings about sensorial depression with a bitter insipid taste. Fetor oris. Movements of chewing; food always tastes insipid, or else bitter. In all illnesses, absence of thirst.

Encephalic cry, especially at night while sleeping.
Convulsions of nursing infants.

Melancholic subjects who are always slow to answer when spoken to. Involuntary sighing. Dull, apathetic, indifferent.

Loss of hair and of the nails.
Mydriasis. Fixed stare without any reason.
Cold sweat on the face.
Always rubbing his nose.

These patients always have diminished vitality. And they have two things that you will notice: anasarca and dropsy. LikeBelladonna and Tuberculinum, Helleborous always bores the head into the pillow. And he rolls his head on the pillow day and night. They eyeballs always gaze upward. Hemeralopia.

Carphological movements during pain.
A very good remedy for patients who get goose flesh.
Frequent and ineffective urging to urinate.
The pulse is generally rapid, faint, and trembling, it can also sometimes be slow.

REACTIVE REMEDIES OF CUTANEOUS AFFECTIONS

Zincum metallicum: The remedy of choice for the results of all eruptions that have been suppressed by any means whether external or internal.

Varicose veins of the legs and the thighs.
Varicose veins of pregnancy which have the characteristic of being painful.
Burning pain of wounds.

The back of the neck, or waist, tired from writing or typing. The child can only see objects by looking at them from the side. He hates anybody to touch his back.

Agitation of the legs and the feet: the syndrome of legs that are restless, like Tarentula, Rhus tox., and Causticum.

Sweating of the feet with excoriation between the toes.

Aggravation especially at night, in the evening, and during menses. Haemoptysis before and during menses.

This remedy has a very special kind of pruritus. It is pruritus of the popliteal spaces, with or without lesion. Eczema, especially behind the ears.
Very sensitive to noise, even the sound of voices.
The child repeats everything said to him before replying.
Forehead cold, occiput hot.
Cross-eyed, rolls the eyes.
Pruritus, especially of the inner canthus.
Pain of the face in general and during headache.
Can’t stand even the slightest bit of wine without headache.

A curious, but precious symptom: cannot urinate except sitting down or leaning backwards.

Involuntary urination on walking, coughing, or sneezing.

Pupils who constantly move their legs to stop themselves from urinating and get scolded by the teacher.

Sudden hunger at 11 o’clock in the morning.
Pain in the left ovary.
The child holds the genitals while coughing.
Lienteric stools.
Gas during stool.

Delicate skin, hypersensitive to the least friction and even to the rubbing of garments, must wear silk underwear to avoid irritation.

Nerium oleander: As you know, this is often used as decoration and we find it growing in large pots in outdoor cafés, with its pretty pink or white flowers.
It acts on the nervous system and brings about, first of all, painless paralysis. It acts on the heart bringing about anxious and violent palpitations. It acts on the skin bringing about pruritus of the scalp day and night, better from scratching.

It also has an eruption with gnawing pain after scratching.

Like Paris quadrifolia, it has the feeling that the eyes are pulled back into the head.

It is a vesicular remedy; eczematous and herpetic lesions. All the eruptions of Oleander are prurient and bleed and suppurate on scratching.

It has a very particular pulse, which I have already spoken about: an arrhythmic and myurous pulse (like a rat’s tail!)

Extreme weakness of the digestive tract.

REACTIVE REMEDIES OF DIGESTIVE STATES
Phosphoric acid: Is a remedy of weakness, lack of vitality.

Growing children who are always tired. Those lanky fellows like stringbeans who are always exhausted and don’t do any work at school.

Rings around the eyes.
Mydriasis.
Exhaustion.
Nervous sometimes from physical or mental overwork.
Onanists, who continually feel guilty.
Indicated after many acute illnesses which have followed each other in rapid succession; loss of vital fluid or after breast-feeding.
Health affected by breast-feeding which exhausts.
After excesses, sorrows, disappointed love, homesickness.
Apathy, and indifference.
Fermentative dyspepsia.
Bites his tongue, especially at night, during sleep.

Frequent diarrhoea, which does not exhaust. He is tired from everything, but not from having diarrhoea!

Always picking his nose.
Occipital headache.
Nicturia; phosphaturia.
Stumbles when walking.
Great desire for fruits, juicy things, and cold drinks.
Thirst for cold milk, like Phosphorus and Tuberculinum.
Neuritic pains in ghost limbs, after amputation
Relieves the pains of Cancer.
Hair prematurely gray.

NOSODES

I already mentioned the principal indication of the Nosodes: when a case does not make any more progress after a first improvement you can give the patient a Nosode to bring about a reaction. And if the Nosode benefits the patient you may continue it: this is in contrast to the other so-called reactive remedies, which one will not continue in these circumstances.

Just to remind you, a Nosode is “a medicine derived from pathological tissues or secretions containing the specific virus of the sickness”

Psorinum: You know that Psorinum is the chronic of Sulphur. This is a very chilly remedy, even in summer. This is also the patient who is dirty and smells bad: even if he washes himself he always smells bad. All the secretions and discharges are very malodorous.
These patients are always hungry and, curiously, especially at night. They will even get up at night to go out and eat. This is very bad for them, because we know that stomach cancer tends to develop in people who can’t stop eating.

Psorinum has a particular pruritus which is an indication and a precious one: pruritus of the external auditory duct.

It is also a very good remedy for constipation in children.

Keynote: feels particularly good the day before falling ill.

Tuberculinum bovinum: As I have often said, this is the only tuberculin, with Avicular tuberculin and Bacillinum, which has been proven on healthy men. As for the other tuberculins, the indications we have are theoretical, arbitrary, conventional, and empirical. The indications of Tuberculinum so readily given, copied, and published by VANNIER are nearly all from NEBEL, and should have been reconsidered, verified, and weighed a long time ago by further provings, I mean by experimentation on healthy man, as in fact any remedy which has the honor of being called homœopathic should be, and one will never stress this point sufficiently.

I have always given Tuberculinum bovinum, when indicated, according to ALLEN and HERING, with excellent results. I cured eruptions, rheumatism, all kinds of cases with this remedy. At the moment I am treating the wife of a homœopathic doctor from Lyon, and she had been treated by many without any results except a constant and immediate aggravation after all the remedies and nosodes she took. To start the case I gave her one dose of Tuberculinum, which ‘opened the case’ as we say, and which benefited her considerably and immediately…. this reminds me of another patient who came from Patagonia by plane with her husband. She had suffered for years from a sort of mixed eruptions on the face, it was acneiform and eczematous, and nobody had been able to do anything for her, and this depressed her morally quite terribly, for she was a pretty woman. I gave herTuberculinum bovinum 10M because she had a little thread in the right eye, indicating a hereditary tuberculinic condition, which was later confirmed by her family history: a paternal uncle (right eye) had been tubercular. And the result was extraordinary: total and permanent cure, after a painful aggravation which lasted two weeks and which she bore with courage.

So this is a remedy which I like particularly, and have no need for any Spengler, Marmorecs, or Denys, etc. … with their purely theoretical and conventional indications.

It’s a wonderful remedy when there is a tubercular heredity, and you can discover this in the eye easily!

Strongly indicated when the symptoms constantly change and the patient catches cold easily.
Emaciation.

This patient loves to travel, journeys and cruises.

He doesn’t like standing, like Sulphur.

Fear of dogs: very good symptom. I have often told you, when I am consulted for infants who take cold frequently and when I find in the eyes of the mother or the father little indications of tuberculosis, I ask three questions: “What are the animals that your child likes or doesn’t like ? “What are his palms like? “When you scold him what does he do?”

Children who need Tuberculinum fear dogs; the palms of the hands are damp; when you scold them, even if they are very little, they lift their fists and threaten you back . . . the naughty things!

Here we have some good symptoms:

Likes refined cuisine.
Likes sweets.
Likes cold milk.

Likes meat, delicatessen products, ham, lard, smoked meat, but certain subjects have an aversion for meat , for wine, and even for all food.

In contrast to Tarentula he has aggravation from music.

And an excellent clinical indication: chronic cystitis (NEBEL).
The pulse is irregular.

Medorrhinum: I am lucky enough to have an excellent source of Medorrhinum. A few years ago I was visiting Seville and there I met a charming homœopathic physician who gave me a quite special gift. You know that Seville is a very pleasant town, full of castanets and pretty women. . . . and also blennorrhagia reigns there as queen! And this doctor had a source taken from a young officer who had had goodness knows how many blennorrhagias! He gave me not one drop of pus but a potentisation which he had prepared himself, a fresh preparation which gave me excellent results. First of all and before everything else, it is in no way necessary to have caught blennorrhagia to benefit from this precious Nosode… fortunately!

Patients who need this remedy find that time passes too slowly.

Many of these patients can’t speak without weeping; they fear the dark and imagine that there’s always someone behind them, and that’s why they keep looking back when they walk!

As you may know, there’s aggravation especially in the daytime.

It has this very special sleeping position; the genupectoral position. Thanks to this symptom I cured a case of epiphora, that is, constant watering of the eyes. My patient was a little girl of five or six who had of course been treated without any result by allopathic pediatricians and ophthalmologists who were nevertheless quite reputed… but of course they were allopaths! I don’t know if you’ve ever seen a specialist introducing a catheter into the lachrymal duct of a child; it’s quite dreadful. First of all one has to find the orifice and in order to do that you have to put a drop of fluoresceine into the eye, and since that burns the child starts kicking, and the fun is on. One really has to have fairy fingers to avoid wounding the eye and causing a retractile scar!

This is where Homœopathy is marvellous: a well-chosen little remedy and everything proceeds smoothly without any dangerous probing. I had given this child several remedies which I had repertorised, but without any result. So I took the father aside and asked him about the illnesses he had had before. That was when he confessed to having had a blennorrhagia in his youth which had been suppressed by the usual injections! After this I learned that the child always slept in this special position: on her knees with her little behind in the air and her head in the pillow, the position which we call the knee-chest position!

Therefore I immediately gave her Medorrhinum 10M and since then it was all over… good-bye epiphora! And yet, you know,Medorrhinum isn’t indicated in the Repertory for epiphora. This is one of the wonderful things about Homoeopathy: the remedy that comes up when you repertorise the pathological symptoms isn’t always the right one. You sometimes have to work back to the chronic miasm to remove the obstacle. It may be rather difficult to see the relationship between a watering eye and the position in which a patient sleeps.

Women sometimes have a very strange symptom, cold breast and, stranger still, especially the right!

Medorrhinum always feels better at the seaside; better lying on the stomach. Fidgety feet syndrome, especially at night; trembling arms and legs.

There are two more disagreeable symptoms (or agreeable ones, depending on the case): sterility and impotence. This is the great remedy for blennorrhagia suppressed by irrigation or some drug that has stopped the infectious discharge.

In women, intense pruritus of the genitals; very malodorous periods; excoriating leucorrhoea smelling of fish; ovaritis, especially left; sterility; intense dysmenorrhoea.

Chronic catarrh which never ends, especially in children; end of nose always cold; constant desire to be fanned; aphthae.

Monoarticular rheumatism: particularly affecting the knee. Chronic rheumatism. Syndrome of fidgety feet; burning hands and feet, but sometimes cold extremities; trembling arms and legs.

Ferocious appetite, even after having eaten; Medorrhinum is always very thirsty; desires liqueurs; desires salt, sweets, warm food; vomiting of pregnancy.

Intense anal pruritus, frequently redness of the anal region in babies.
Nocturnal enuresis.
Finally, intense itching of the skin.

When we study the Nosodes together we shall have to write them into the repertory, because it has only a very small number of indications.

Syphilinum: All symptoms aggravated at night.
These patients are always washing their hands.
A feeling as if the sternum were pulled backwards against the spinal column.

Despair of recovery, like Calcarea, Arsenicum, and Alumina. Like Nux vomica, these patients are completely exhausted in the morning.

Desire for alcoholic beverages.
Erratic rheumatism.
Better in the mountains.
Profuse salivation at night on sleeping, and like Mercurius it soils the pillowcase.

When you study your cases you come up with one principal remedy and several satellites: look for the miasm which corresponds to these remedies. If these remedies belong to the three kingdoms, mineral, animal, and vegetable this means that the case is profoundly deep rooted. If there are only mineral remedies this means that it will be a long chronic case and will be difficult to cure. If there are only animal remedies, you can expect complications and difficulties of every kind: this case will be troublesome because of the patient’s reactions. And if you have only vegetable remedies it means that the cure will be easy. Find out also if these remedies are exclusively sycotic or psoric or syphilitic. Contrary to what NEBEL believed, tuberculosis is not by any means psoro-syphilis, it is psoro-sycosis. In the eyes one can also see syphilitic heredity, even several generations back.

Night terrors in infants.
Falling hair.
Patchy alopecia.
Recurrent keratitis.
Although one of the principal indications for Nosodes is an improvement which stops and goes no further (when the therapeutic progression is arrested), one may give them right from the beginning, especially when there is a lack of reaction. As you know these are remedies of an entirely different kind.

Sulphur is a very great reactive remedy but it has the great inconvenience of awakening symptoms just about everywhere and sometimes gives us very disagreeable aggravations; and that is why I haven’t mentioned it in the reactive remedies. Still, it is one of our best reactive remedies. Of course one will think of giving it after some other remedies which already have brought some improvement; as a general rule avoid giving it at the beginning of a case.

When you have a defective case, think also of going back to earlier symptoms from the beginning of the illness, old symptoms on which you will be able to prescribe the remedy which the patient should have had before; that remedy can still help him.

After having studied the reactive remedies we should read what HAHNEMANN has to say in Paragraph 184 of his Organon. “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 homœopathic remedy sought for, as suitable as possible for the group of symptoms now observed, and so on until the recovery is complete”.

Of course, this means questioning your patient again. If you don’t know which remedy to give, don’t hesitate to give Saccharum lactis. Do not give a remedy if you have no clear indication. You will never regret having given Sac lac., but you will always regret having given something which will have upset your case.

I have already told you how Dr. MATTOLI used to manage his practice at the beginning of the vacation period. You know that he was a very short man. He used to dress all in white and in July received his patients not in Florence where he lived, but in Viareggio, in an enormous and magnificent property. That is where he invited my wife and me one summer. For ten days he served us chicken every day! The chicken was exquisite because each time it was differently cooked. One day he prepared polenta on an enormous marble table; it was very amusing. Well, on one occasion the chicken wasn’t cooked exactly as he wanted it, and he went to the kitchen. We heard dreadful screams. He slapped the servant in the kitchen a couple of times (and even rather more than a couple of times) – as that was the way he did things – and then he came back to us, much calmed down and quite happy; and we were able to eat our chicken … in peace!
“When it is time to go on vacation”, he used to say, “one is overworked, a great many people keep telephoning, one is harassed and makes wrong prescriptions.”

And so, to avoid prescribing wrongly, he used to sit out in the country under a wonderful oak tree, with his secretary at his right hand, and all his case histories. People used to come on horseback, on foot, on bicycles, in motor cars, in carriages… it looked like a camp that had been set up. There must have been at least 200 people! And so Dr. MATTOLI received them under his tree one after the other, and each one of them asked for a remedy for an uncle or an aunt or the cook or the dog or the cat as well – it was dreadful! I can tell you that he didn’t waste any time and didn’t ask anybody to do a complete strip-tease to auscultate them! But everything worked out very well with the heat of summer and the volubility of the beautiful Italian language! Next to him there was cupboard of remedies, and our colleague prescribed for everybody Sac lac… And he had noticed that with the help of the holidays there were hardly 10 percent of the patients who were not much improved when he returned in autumn. Naturally, serious cases didn’t come to the country to see him! Fortunately!

Paragraph 185: “Among the one-sided diseases 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”.
Paragraph 186: “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 diseases. 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 homœopathically subdued, then the services of the dynamic physician and his helpful Homœopathy come into requisition”.

Apropos of the Vital Force, KENT mentions these illnesses which are not local (as they are wrongly called), but, instead, localized illnesses: when it is an illness that is not surgical, when you have, for instance, an eruption or a small tumor somewhere.

Paragraph 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 application or other similar remedies – as the old school have done from the remotest ages – is as absurd as it is pernicious in its results.”
For instance, traumatisms often quite benign can be the cause of Osteosarcomas or Carcinomas, which appear years later.

Paragraph 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.” [4]

Of course, HAHNEMANN was not very tender … but people were even less tender toward him; and I find that he was even modest in his remarks!

Paragraph 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 cooperation 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 individual whole in sensations and functions. No eruption on the lips, no whitlow can occur without previous and simultaneous internal ill-health”.

Except for these traumas, there are therefore no local illnesses. There are only the localized illnesses of a general state of health that is deficient.

There are things which we cannot understand. How can one have, for instance, an eczema of the foot and a wart on the ear and strabismus all at the same time? We cannot see at all the connection between these three things and yet they are connected by some biological unity. And that is why we have to base our decisions on the totality of the symptoms in choosing a remedy. And even if we don’t know the relationship which unites these different morbific complaints, it exists nonetheless; and it is thefundamental unity that is reached by our constitutional remedy.

It is very important to meditate upon these paragraphs.

These illnesses are defective; they are partial illnesses, localized illnesses, which we call apparently local. To mention a few of these, we have:

Surgical affections which can be treated by Homœopathy: I mean, one should always treat the patient before an operation. And we see, if we are good prescribers like Dr.WARD, of San Francisco, famous for his excellent work Unabridged Dictionary of the Sensations ‘As if’, that a certain number of operations can thus be avoided. Dr. WARD was a Surgeon, a Gynecologist, who became interested in Homœopathy, and stated at the end of his life that 40 percent of the patients who came for an operation no longer needed to have that operation after they had been prepared for the operation homœopathically! In addition, his colleagues were jealous of him and couldn’t understand why his operations were more successful. When one can prepare a patient who must undergo a surgical operation, there are two things to which I always call people’s attention. First of all , I take the biological rhythms of FLIESS into account to determine the most favourable date for the operation. In this way I avoid a great many postoperative complications.

Recently a patient whom I was treating for his general health and who lives in Ungerdien came to see me to ask about having a hernia operation. This was a perfectly straight forward inguinal hernia. I calculated his biological rhythms and advised him about a suitable date. Naturally, surgeons have a thousand and one reasons for not doing what one asks them to do. This patient’s surgeon couldn’t operate on him on the date he requested and started laughing at him when he spoke about biological rhythms! He operated outside of the good dates. Of course, the operation was very successful, but on the seventh day after the operation the patient felt a pain half way up the inner surface of the thigh as if he were being poked by a red-hot iron every time he stood up. And the surgeon whom he had consulted came and said to him: “Listen, here, sir, this is none of my business. We operated on your hernia and everything went well. Your testicles are not swollen, and you ought to be grateful because that often happens. The trouble you have there is neuralgia and you had better see your doctor about it!” So the patient telephoned to me and asked me what he should do … and I was very annoyed. He wanted to come to Geneva, but it was quite impossible for him to get into a taxi because the pain was so intense! Naturally, when one doesn’t see the patient one cannot always think of everything. Nevertheless, I blame myself for not having been more thoughtful because, after all, after a hernia operation one can easily have reactions of the testicle, and other reactions, too, which are well known.

Neither rest, nor the anticoagulants administered had the slightest effect on the distorting pain felt as soon as he sat down.

We are surprised to discover that it is almost intolerable not to be able to sit down! You can’t, after all, remain standing or walking all the time! What a benediction it is to be able to sit down! May be you have never thought about it … Well, finally, the worried surgeon told him to go to see a doctor because it was none of his business! And this went on for three weeks!

I encouraged the patient to try to come to Geneva, but this meant six hours in the train with no hope of sitting down… how happy that was! When he arrived in Geneva, I administered a few points of Acupuncture, which relieved him a little. I gave him first of allHypericum 10M, and two days after discovering that this was in fact a neuralgia of the spermatic duct, a funiculalgia, Hamamelis200 (page 702 of the repertory) every 6 hours for two days. This cured him completely and permanently.

I really think that if one takes into account the rhythms of FLIESS one can avoid a lot of trouble. For instance in blood transfusions, I am thinking of a colleague from Zurich, a great specialist of transfusions, who one day had to give his wife a blood transfusion: well, although he was nearly always successful, this time his wife had an embolism …. and died! He had operated on her on a day when her three rhythms changed simultaneously.

CARLETON, an American, has published a book which I recommend to you, called Homœopathy and Surgery. He was a pure homœopath and an excellent surgeon, and in this book he gives excellent advise on the homœopathic treatment of many surgical cases.

In sprains, after manipulation, when this is necessary, Homœopathy offers a whole palette of very precious remedies which considerably shorten the convalescence and ease the pains. Distensions of the muscles or the tendons of the hand or foot, with or without injury of the periosteum and the bones, can be relieved and often cured in record time after putting them back in position by rubbing with oil of Rhus or tincture of Arnica and bandaging tightly; after this, one should administer a so-called trauma remedy.

In the Repertory on page 1371 you will find remedies for all kinds of distensions of the ligaments, sprains, luxations… etc… in the rubric “Lifting, straining of muscles and tendons.” and you can very easily combine this rubric with “Pain, as if sprained” you can add the following remedies: arn., Bell-p., led., mill., ruta, Agn-c., Am-c., Asaf., Carb-an.

Under “sprained” you can add “chronic”, when the complaint becomes chronic: there is a remarkable remedy indicated by HERING which I have often verified, and that is Stront-carb. The 10M potency works beautifully!

On page 983 you have “Dislocation”: spontaneous, of the hip: of the kneecap; of the ankle.
If there is weakness of the ligaments look at page 1232 “Weakness, ankle, while walking”. And you can add to that rubric Calc-p. For children who are late in learning to walk”: Carb-an.
On page 364 you will find spontaneous dislocation of the jawbone (“Dislocation of jaws easy”), and add to that rubric Caust, andPetr.

On page 1019 under “Injuries, hand, sprain” you can add Bell-p.

Where we have fractures of course we have to assure the mechanical replacement of fractured bones. But after this, homœopathic remedies considerably aid osteogenesis and shorten the time of knitting. Usually I give all my patients with fracturesSymphytum 30 liquid, six drops three times a day for a month, if there are no other personal symptoms. You will find fractures on page 1402 under “Slow repair of broken bones”. On page 1008 you can add the rubric “Fractures” Just before “Freezing”, with the following remedies: Calc., calc-p., calen., ruta, sil., symph., and under the following rubric: “Consolidation retarded”: ferr.,

On page 1402 “Slow repair” add Calen., ferr., iod., mang-ac., mez., Ruta., Symph. and thyr. (CLARKE)

If we have retarded ossification in children think of Calc., calc-f., Calc-p., and sil.
Come back to page 1008 and add under “Fractures”: (HERING)

“of cranium”: calen
“infected, with suppuration”: arn.
“open”: calen.
“of tibia”: anthr.

On page 1368 you will find the rubric “Injuries”, which includes blows, falls, ecchymoses … etc. Add Acet-ac., acon., ang., bufo,calen., camph., crot-t., glon., ham.,
mag-c., mill., phys., stront-c., verb., and on the following page under the rubric “with extravasations” add led.

For insomnia after fractures or after surgery think of stict.
For contusions of the nerves, on page 1369, add bell-p.,
For contusions of soft parts add ham., and symph.
In contusions of the tendons add calen.

BOERICKE indicates for contusions: acet-ac., arn., bell-p., con., echi., euphr., ham., hyper., led., rhus-t., ruta, sul-ac., symph., and verb.

And for the chronic results of traumatisms: arn., carb-v., cic., con., glon., ham., hyper., led., nat-s., stront-carb.

On the last page of the Repertory, page 1422, you have the whole question of ‘wounds’;. under this rubric you can add ‘lacerated’: arn., calen., carb-ac., ham., hyper., led., staph., sul-ac., symph. (BOERICKE).

Under the general rubric “wounds’’ add calen., carb-ac., helianathus, (CLARKE).
Under “bites” add: Lob-pur., and Seneg.
“snakes”: thuj.;
“bleeding freely”: am-c., dor., ham., lat-m., nit-ac., ph-ac., sanguisuga.
“crushed”: carb-ac., ruta;
“cuts”: calen, ham., hyper,;
“decubitus, see sore”: all-c., tub,;
“gangrene, tendency”: calen., sal-ac., sul-ac., (BOERICKE);
“painful” all-c.;
“penetrating”: phaseolus;
“painful injections” : crot-h., led,;
“to remove thorns, splinters, fishbones”: lob., sil.;
“proud flesh”: sil.;
“if the injured part feels cold to the patient and to objective touch”: led.
Under “Burns”, page 1346, add acet-ac,. acon., arn., calc-p., calen., camph., gaultheria., grin., ham., hep., jab., kali-bi., kreos., ter., urt-u.;
“burns from X-rays”: calc-f., x-ray;
“burns fail to heal, or ill effects”: carb-ac., caust.

On page 1304 you will find something which may often help you, “cicatrices”. For keloids you will combine the two rubrics “elevated” and “hard”. In the rubric “hard” you should put graph., into the third degree and add fl-ac. CLARKE recommends an ointment with Staphysagria in the mother tincture.

For keloid scars there is whole series of remedies to be added. I found them during my searches in the works of the great ALLEN, BOERICKE, CLARKE, JAHR, LILIENTHAL, STAUFFER, and DOUGLAS: ars., bell-p., calc., carb-v., caust., crot-h., fl-ac., graph., hyper., iod., junc., lach., merc., nit-ac., nux v., ophiotoxicon (JAHR), phos., phyt., psor., rhus-t., sabin., sil., sulph., sul-ac., thios., tub., vipera.

I gave you some examples of so-called localised affections, and now we shall see how to find the remedy in defective illnesses. You have a patient who comes to consult you complaining of only one symptom, or of very vague problems; what are you going to do in such a case, and how are you going to find a remedy which can help him?

First of all, before looking for a remedy one should always start by eliminating any habits or extraneous circumstances which might be the cause of the patient’s disorder, as HAHNEMANN said at the beginning of his Organon.

Here are some guidelines which we must bear in mind for every illness:
(1) One must correct the diet. CARTON was right to insist on this point, for it can bring considerable improvement to patients. It is dreadful to see the diet which some people follow. This reminds me of a certain patient who always keeps a magnificent box of chocolates just inside of his front door: he offers some to anybody who comes to see him and this gives him an opportunity to have some also. One of my women patients, whom I sent to see one day for an influenza, had one kilo of candy next to her bed, and from it she would serve herself generously during the night whenever she woke up. She was surprised that she was overweight and that she always had liver trouble!

(2) One has to pay attention to the way patients live, their hygiene and their exercise. Advise them to do fifteen minutes of exercise every morning: generally they never do it! A good idea is to have them take lessons in physical exercise from some teacher whom they have to pay. There are stationary cycling and rowing apparatuses which people buy to use at home, and never use for more than one month after buying them at considerable expense! Tell them to take lessons in riding, or tennis, or gymnastics. Then there are also those patients who never take holidays, and for whom the only thing that counts is their work. If you can’t get them to take holidays like everybody else, tell them to go on a cruise, or propose some hydro-mineral cure which is as harmless as possible, and which will oblige them to some sort of regular schedule and rest for at least a month. Then of course there are fasts, which can be prescribed for those who can stand them.

(3) Examine the spine, and if necessary send the patient to a chiropractor for any necessary adjustments. This is very useful sometimes, and one shouldn’t neglect it.

(4) Don’t forget the dentist. There are people who never go to the dentist. Look at your patients’ teeth, carefully sound them, apply heat or cold with a moist wad of gauze. You may find people with unbelievable things in their mouths. I will never forget a certain society lady who had twenty seven of her thirty-two teeth absolutely bathed in pus! And she didn’t feel a thing. She had to have all her teeth out, and now she’s quite well.

(5) Examine the ears. You would be surprised to know how many people go around with plugs of wax as hard as wood in their ears, and how grateful they are when you clean out the ears!

(6) Habits. Some people have dreadful habits: some people wear the same clothes for at least twenty years – what a shame! — for instance, a dirty old jacket, all worn-out, or a venerable raincoat. Disgusting! Get them to buy new clothes, and something in their manner changes immediately. In the apartment get them to change the position of the furniture or to swap rooms, or to change pictures on the walls, and their whole condition might change! Especially when there has been some mourning in the family, get them to change the position of the furniture: in this way the ‘perpetual presence’ (and sometimes the very trying presence) of the dear departed is dissipated.
Only after all these steps you can start asking yourself what remedy you are going to prescribe. And this is difficult when there are almost no symptoms. When we have what we call a deficient illness you have to have some imagination to see what can be done.
(1) The first thing to look for is the etiological symptoms: “ailments from …”: anger (p.2), anticipation (p.4), contradiction (pp.2/512), egotism (p.39), emotional excitement (p.40), fright (p.49), grief (p.51), homesickness (p.51), wounded honor (p.52),indignation (p.55), disappointed love (p.63), reproaches (p.71), rudeness (p.75), scorn (p.78), thinking of complaints (p.87), vexation (p.21), mental work (p.95)

(2) You can also find very good information in the hereditary symptoms: those that come from the mother to a boy, from the father to a girl. Take into account also the particular symptoms manifested by the mother during her pregnancy, and during her labor.

(3) All suppressions must be noted. Cutaneous affections, discharges; leucorrhea, gonorrhea, sweat, coryza, etc. For the result of polypharmaceutic practices; even before you think of any other remedy you can always give them Nux vomica.

(4) Vaccinations which either didn’t take, or did take. If there was a reaction and it was too strong, this is a good point to start from in prescribing remedies of Vaccinosis, p.1410. If the vaccination didn’t take, it means that the individual was either too weak to react, or that the vaccination was no good.

(5) Childhood diseases. What interests us particularly are affections of childhood which left after-effects: the child didn’t recover quickly, the cure was not clear-cut. Some of them cough for a year or two after whooping cough, and others have endless eye trouble after the measles. We know that scarlatina and mumps can leave consequences and continue to act on the general condition in a dreadful way. The same applies to chicken pox and diphtheria. In these cases think of giving a Nosode which corresponds to the illness, either in the 30th, 200th, or, better, in the 10M potency.

(6) There are rubrics which are absolutely objective: the rubric “Old people” – consult it if your patient is more than 60; the rubric “infants” which is not in the present Repertory but was in the first edition, and which I have advised you to add to the present edition; the rubrics for nursing mothers and pregnant women.

(7) Observe the periodicity.

(8) Observe any obesity, thinness, or varicose veins.
You can find these manifestations in the Repertory and they can help you a great deal.
We can’t find very much under general symptoms in defective illnesses. The patient will complain of weakness, general tiredness, without being precise. If the symptoms are there, think especially of seeking out and noting chilliness or warm-bloodedness, and any reactions to extremes of temperature.
As for mental symptoms, here again you won’t find much, unless this illness is defective only because the doctor is! We are in the habit of asking a great many questions, but, in addition, there are a multitude of little things which we forget because we can’t keep everything in our minds—especially if we are defective doctors! Which are the mental symptoms we haven’t thought about? We can have a patient who has no fears or anxieties at present, but who may have had some in his youth. Quite often we forget these; for example, fear of solitude, of darkness, of robbers, of storms, of water, of animals. Remember that the individual is, after all, a biological unity.

Often we forget to find out whether our patients were somnambulists during their youth.

Now, concerning ideas of suicide, this is a touchy subject. One should try first of all to bring up the subject indirectly: “In certain difficult moments of life there are people who ….”, and from the corner of your eye you can look at your patient to see if he reacts. And if they come to talk to you about wanting to commit suicide, they are reassured just from this little remark. Don’t forget also that the flattening of the pupil at twelve o’clock is an indication of this.

You can see so many things. For instance, if the patient starts when the telephone rings, or when a door suddenly slams.

Always find out about weeping: involuntary weeping, uncontrollable weeping, weeping during sleep, etc. And ask them also whether they feel better or worse from it.

Then there is the question of vertigo, which can give us very precise indications when we know how to ask the right questions. For instance, if our patient has vertigo while walking we should find out in which direction he feels pulled: forward, backwards, sideways (and if so, to which side). Always ask whether the vertigo disappears when he closes his eyes. Then there are vertigos which rotate, or vertigos which give the feeling of being pressed under, or of swaying, vertigos with headaches, or with dimness of vision, vertigos from heights, vertigos looking upwards, lifting the head, vertigos looking at objects which move, for instance, cars in the street.

Now, as for the head, you know that Dr.TYLER had a particular predilection for headaches. She said that this was her favourite rubric in all the Repertory. It is true that this is the chapter which is most carefully elaborated in its modalities and pains. As a rule patients have great difficulty telling you the kind of pain they feel. But don’t let us forget to ask how the pains appear: do they appear and disappear quickly or gradually? You will find this information on page 141, “increasing gradually”; page 149, “sudden pains”; page 151, “waves of pain”.

Ask them also about spots before the eyes, which are a frequent and precious indication of Iris versicolor in headaches.

There are also headaches with constipation (p.138) or with colds (p.138). The feeling that the head is empty or full can sometimes help one. Ask them also about the extension of the pains.
One forgets sometimes perspiration of the head, its locality and modality. Sometimes they perspire all over the body and not on the head.

Some people have sensitivity of the scalp from brushing or combing the hair; others can’t stand the warmth of a hat (p.121, carb-an., iod., led., lyc.,), or on the contrary, can’t go without one (p.233, “uncovering”)

On page 229 you will find the rubric “Sensitiveness of brain”, you should add: “even to hat”, bry., carb-v., chin., crot-t., hep., merc., mez., nit-ac., sil, staph., sulph. Some people cannot stand pressure, for instance, the weight of a hat, and this corresponds to mez. and nit-ac. according to GENTRY . Under this rubric “Sensitiveness from brushing the hair” you may add Viburnum.
There are patients who have constant headaches, they never stop: and there are two rubrics: “chronic” headaches, (am-c., ars., caust., con., sil., sulph., ter., tub.) and constant continued” headaches, on pages 137 ad 138 respectively. For this kind of headache there is a Nosode which you may think of and which may help you very much: Meningococcinum. On page 139 you have headaches after haircuts (bell., glon., led., puls., sabad., sep.), and on page 151 “pain from washing head”. There are also dreadful headaches, badly described, which are often rheumatic headaches (p.146). Then there are wandering headaches or headaches in spots. (p.148)

People never have enough time to examine the eyes thoroughly. But they reveal useful symptoms which the patient will not always tell you.

Eyes which are glued, closed in the mornings.
Accumulation of eye gum in the corners of the eyes.

Cracks and fissures. Look for them on the face. You may find them in the outer canthi of the eyes, of the mouth, of the nose. Sometimes they are uricemic. Make your patients sweat, make them take exercise, change their diet, and quite often these little crevices will disappear. There are little cracks on the corners of the nostrils (p. 329, “Cracks”), and at the insertion of the ear (p.288, “Eruptions behind the ears”).

The pupils: see their degree of dilation or contraction; anisochorea. Unequal pupils often indicate vago-sympathetic disturbance.

Blepharo-spasms. In the Repertory there are three terms which are rather alike. Usually these patients are too tense. They need holidays and rest. In the Repertory look under “Quivering” on page 264, “Twitching”, and “Winking”. A remedy which has often brought me success and which you can add under “Quivering of lids” is Aranea scinencia. PATERSON’s Dys-co. often succeeds also.

Convergent or divergent strabismus.

Chalazions: look to see if they are on the upper or lower lid. The location can help you.
Swelling of the eyes: upper lid or lower lid, or beneath lower lid. Sometimes there is a little swelling of the inner corner above the upper lid, and this can be a sign of hernia. It is also often a typical symptom of Kali carb. (p.355, “Bloated, between lids and eye brows”).

Cold tears, burning or salty tears.
Hemeralopia.
Disturbances of refraction; you know for instance that a typical remedy for astigmatism is Tuberculinum.
Marginal blepharitis is often well taken care of by Bacillinum 30 once a week.
Falling eyelashes and eyebrows.

Look at the conjunctiva, whether they are red, pale, or yellowish. Sometimes they will indicate little attacks of jaundice: in that case look also at the palms and the palate to see if they are yellowish.
Some patients constantly rub their eyes (p.265), and this must not be confused with those who wipe their eyes (p.270).

Nystagmus: find out whether it is horizontal or rotary.

The ears: Sometimes when you look at your patients’ ears you see that there is cotton-wool in them and you ask why. “Well it’s because I can’t stand cold air!” And then you have the remedies for this little symptom: Acon., clem., hep., lac-c., merc., sil., thuj.

Some people don’t know that they had bad hearing in one ear. Similarly some people don’t know that they see poorly in one eye; it is up to you to verify these matters.

Always ask your patients if they can perceive the direction from which sounds come: you know that Carbo animalis is the great remedy for those who don’t know where the sound is coming from.

Others don’t hear anything at all when many people are speaking at once: there are even people who hear better in a noise!

The nose: The nose also can be very sensitive to the intake of air. There are people who are always picking their nose, and it is often a symptom of worms. Also it may be the sign of a frustrated libido.

As for colds (which doctors fear, because they don’t know what to give!), Homœopathy often succeeds admirably. One could say that eighty percent of the patients who have a cold are immediately improved with Aconite 200. We are more interested in obstructions than in discharges, and, in that connection, there are some questions which one would do well to ask properly: On what side? Day or night? In a cold or in a warm atmosphere?

Sometimes it is obstructed and it runs at the same time.

There is a special rubric for obstructed nose in children, and it has excellent remedies: Am-c., ars., asc-t., and for nursing babies:aur., kali-bi., lyc., nux-v., samb. (see NOSE, obstruction p 341)

Dry noses are generally hard to cure.

As for epistaxis, CLARKE highly recommends Ferrum picricum: he says this remedy succeeds better than all the others. Viperaalso often succeeds very well for nose bleeds, especially if the blood is dark. There is also a rubric for epistaxis in infants, and the remedy which succeeds most often is Ferrum phos. (Abrot., bell., chin-s., croc., ferr., ferr-p., ferr-pic., ham., merc., phos., ter.). Think also of epistaxis at night, washing the face, and all the other possible modalities for which there are specific remedies.

Ask your patient about his sense of smell. Then again sneezing is very important in finding the remedy, and don’t forget the modalities. You remember the morning sneezes which is a very good symptom of Ammonium carbonicum.

Face: We already spoke of chapped skin, cracked skin, excoriations. Cracks in the upper lip will make you think especially of Kali carb. and Natrum mur. If there are cracks in the corner of the mouth there are a whole series of remedies: this is the famous angular cheilitis, or commissural exulceration, which is often a sign of a lack of vitamin B2.

The tongue can also have fissures, especially on the sides, and in the middle, and on the tip.
Always look at the complexion, the colour of the face; and look also at the expression. In the Repertory there is a rubric which gives very detailed attention to the expressions of the face: surprised, anxious, worried, aged, tired, sickly expression, etc. Sometimes these signs will help you to find the remedy. Look also at the wrinkles and the frowns. They may be important.

The perspiration of the face may be hot or cold, or may appear only on one side, or on the upper or lower lip etc. Some people only perspire on the nose (and of course the classic remedy is Tuberculinum bov.)

Mouth: Sometimes the aphthae in the mouth are very troublesome: sometimes also the fault lies with the dentist with his little wads of cotton powdered with Borax. Look at the location of these aphthae: they may be on the gums, on the tongue, or on the lips. You might try a little mouth-wash with lemon juice: it hurts at first, but sometimes it feels much better afterwards. My professor of ophthalmodiagnosis had another method: he used to use a little wad of gauze saturated with an infusion of Chamomilla, with which he scraped the aphthae until they bled… and that was that. On page 397 you will find aphthae of the mouth, and in the general rubric you might add: Sempervivum tectorum (Houseleek). Add also, cinch-b., ill., ip,., while phos., sars., and semp…, should be in italics.

Lower down, under “in children”. add bapt., asim., kali-br., plant., viol-t. Add “in infancy”: bry., and “in influenza”: ant-t.

Think of Kali mur when the aphthae progress towards ulceration.

And for aphthae of the lips: cadm, cinch-b., cub., ip., jug-r., kali-c., mur-ac., hep., merc-c.
For aphthae of the palate add: Sempervivum, sul-ac, and underline phos.
Look at the tongue, whether it is dry or wet, whether it oscillates or trembles.

Among the different smells of the breath there is one so disagreeable that we call it ‘sickening’: it makes you sick if you have to be subjected to it! In such cases, before thinking of a remedy, you might advise the patient to buy a tongue rake, and to use a mouth-wash of calendula lotion after it.
Some patients sleep with the mouth open (p.409).

On page 417 you have the rubric ‘Salivation”. In the main rubric delete calad., and add: aur., calc-ars., eucal., hipp., merc., nit-s-d., phys., squil., ter., ust., verat-v., vinc., xanth.

Under “salivation” add the following rubrics and remedies:
“night”: culex, merc-c.
“acrid”: lact., merc.,
“angina, in”: bar-m.
“aphthae, with”: hell., merc., merc-c., nat-m.
“apoplexia, in”: anac., nux-v.
“asthma, in “: carb v.
“cardialgia, in”: puls.
“children”: camph.
“chill and fever, with”: stram.
“coryza , with”: calc-p., cupr-ac,
“dentition, in”: hell, merc., nat-m., sil.
“dribbling”: stram.
Under “dryness, with sense of”: add kali-m.,
“esquinancia”: anthr.
“fetid breath, with”: kali-br.
“fever, during”: sulph.
Under “headache, during”: add cinnb.
“measles, in”: nat-m.
Under “mercury, from”: add hydr.
“mumps, in”: nat-m.
“nausea, with”: Ip., camph,., carb-s., chin., lach., sulph., verat.,
Under “pregnancy, during”: add Ip., goss.
“prosopalgia, in”: mez., plat.
“scarlatina, in”: Arum-t., caps., Lach., merc., sulph.,
“malignant”: Am-c.
Under sleep, during”: add a note to “(see night)”, and add cinch-b., dios., ip., and put kali-c into italics.
“sleep, preventing”: ign.
“speaking, constant while”: graph., lach.
“spit, with constant desire to “: cocc-c., cadm-s., graph., grat., lac-c., lyss., puls.
“swallow, constantly obliged to”: ip., seneg.
“toothache, with”: Cham., daph., kali-m., nat-m., and add a note to “(See Teeth, pain, saliva, with involuntary flow of, p.438)”.
“tonsillitis cough, in”: Bar-c.
“whooping cough, in”: bry., iris-v., spong.
Then there is “Speech, stammering”, page 419, and “speech, lisping”, page 419.
Ask about the sense of taste: the loss of taste or different perversions of taste.

Teeth: You have to examine the teeth of your patients: any caries, the color of the teeth, and any deformation; then you have the untidy tooth of Topinard, which of course is none other than the wisdom tooth! From my personal experience, one should always extract a wisdom tooth if it causes trouble or grows wrongly.

Throat: Always look at the condition of the uvula: it hangs like a little sack of water; perhaps there are aphthae on it, or small whitish deposits. One should examine the tonsils also.

Neck: Notice whether your women patients wear a scarf; some of them can’t stand having anything round the neck.

Then there is the whole question of goitres: I confess that I have never managed to make a goitre disappear. Sometimes my patients have said that they felt much better, but on measuring the neck I noticed that there was no change – it was purely subjective. But after having treated patients with a goitre for a certain time for their general condition, you may find that they tolerate an operation on the goitre very well, without any after-effects.

Food desires and aversions: From page 480 on you will find all the aversions to food, and you may add the following:

Under “cheese” put olnd. into italics and add: arg-n., nit-ac., staph.
and add the following subrubrics:
“Roquefort”: hep.
“strong”: hep., nit-ac.
“Swiss(Gruyere)”: merc., sulph.
“chicken”: bacillinum (ALLEN).
Under “fruit” add: ars., Chin., Puls., carc., and add the following sub-rubric:
“green”: mag-c.
Under “milk” add: carc., Staph.
Under “onions” add: thuj.
Under “salt food” add carc.
“strawberries”: chin., sulph.
Under “sweets” add nux-v., puls.
Under “Desires”, from page 483 on, make the following additions:
Under “alcoholic drinks” add the following subrubric:
“habit , to remove”: stry-n. 3x
Under “beer, evening”: add med., and put zinc. into italics.
Under “beer” add another sub-rubric: “thirst, without”: calad.
Under “chocolate” add: carc., sep.
“fat food, which aggravates”: ars., hep., Nit-ac., nux-v., sulph., tub., carc.
Under “fat ham” add carc.
Under “indigestible things” add: nit-ac., nux-v.
Under “lemons” add bell., nabal.
Under “meat” add the following sub-rubric:
“children, in”: mag-c.
Under “milk” add carc.
Under “onions, raw” add thuja
Under “salt things” add carc.
Under “sweets” put merc. into italics, and add under “sugar” the following sub-rubrics: “only digests if he eats large amounts of sugar”: nux-v., Staph.
Under “tea” add puls.
Under “tobacco” add: med., nicotine, plant., and add the following sub-rubrics:
“to remove desire for”: calad., calc., Caust., ign., lach., nux-v., petr., plan., Staph., sulph. (GALLAVARDIN)
“tomatoes, raw”: ferr.

Desires sweet and sour foods at the same time: bry., calc., carb-v., kali-c., med., sabad., sec., sep., Sulph.,

Desires sour and salty food: arg-n., calc., calc-s., Carb-v., con., Cor-r., med., merc-i-f., Nat-m., Phos., plb., sulph., thuj., Verat.

Desires sweets and salt: Arg-n., Calc., carb-v., med., plb.,

Desires sweets, which aggravate: am-c., Arg-n., calc., nat-c., Sulph.

Stomach: Eructations can help us a great deal: so can yawning and sneezing. Some eructations ameliorate, others aggravate. Ask your patient about the taste of these eructations. You will find from page 489 onwards. There are noisy eructations, others that are controlled.

Ask your patient about hiccoughs, and if he has hiccoughs modalities can be very important. If you make a medical certificate, never mention the word “hiccough”, but speak instead of “phrenoglottic myoclonias”, which makes a very good impression and forces people to look in the dictionary: You will find hiccoughs on page 501, and under the general rubric add: ambr., amyl-n., ars-h., calad., cupr-s., hydr., hydr-ac., med., lyss., sin-n., staph., stront., tarax., and make the following additions:

Under “night” add the following sub-rubric:
“urination, with involuntary”: hyos
“apoplexy, in”: Ol-caj.
“asthma, begins attack of”: cupr.
“back, with pain in”: teucr.
“carried, when, in cholera infantum”: kreos.
“children, in”: bor., ign., ip.,
“nursing, while”: hyos.
after”: teucr.
“restlessness at night, with”: stram.
“cholera, in”: aeth., arg-n., cic., cupr., mag-p., ph-ac., verat.
“concussion of brain, in”: hyos.
Under “convulsions, with” put cupr., into italics and add stram.
Under “cough, after”: add ang.
“diarrhoea, with”: cinnam., verat.
Under “dinner, before”: put mur-ac. into italics.
Under “dinner, after” put phos., into italics.
Under “drinking, after” put puls. into italics.
Under “eating, after” add: fil-m., ham., and put par. into italics.
“emotions, after”: ign.
Under “eructations, after” add: ars-h., ox-ac.
Under “fever during” add the following sub-rubric:
“yellow, in”: ars-h.
“fruits, after cold”: ars., puls.
“gastralgia, with”: sil.
“gastric affections, in”: kali-bi.
“hepatic colic, in”: chin.
“hepatitis, in”: bell
“intestinal intussusception, in”: plb.
“migraine, in”: aeth.
“meningitis, in”: arn.
Under “painful” add mag-p., and add the following sub-rubric:
“causes crying”: bell.
“peritonitis, in”: hyos., lyc.
“salivation, with profuse”: lob-i.
“sitting up straight”: kreos.
Under smoking, while”: add calen., scut., and put ign. and sang. into italics.
“spine, in affections of”: stram.
“stomach, in cancer of”: carb-an.
Under “supper, after” add coca.
“surgery, after”: hyos.
Under “typhoid, in”: add mag-p.
` Under” vomiting, while” add: bry., jab., jatr., Verat., and add the following sub-rubrics:
“before”: cupr.
“terminates in”: jab.
“winter, in “: nit-ac.

For slow digestion add the rubric “slow” on page 526 (and make cross references to “Inactivity” on page 503, and “Disordered” on page 486):aur-m., berb., Chin., corn., corn-f., cycl., eucal., lyc., nuph., nux-v., op., par., sabin., sep., Sil., Tarent.

Cardio-pyloric stenosis: see pages 483, 504, 511.

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The friend of health (Hahnemann, 1791) – Part i – Protection against infection in epidemic diseases

 

For every kind of poisonous exhalation there is in all probability a particular antidote, only we do not always know enough about the latter. It is well known that the air of our atmosphere contains two-thirds of a gas that is immediately fatal to man and beast, and extinguishes flame. Mixed up along with it is its peculiar corrective; it contains about one third of vital air, whereby its poisonous properties are destroyed; and in that state only does it constitute atmospheric air, wherein all creatures can live, grow and develop themselves.
The suffocative and flame-extinguishing exhalations in cellars in which a quantity of yeast or beer has fermented, is soon removed by throwing in fresh slaked lime.
The vapour developed in manufactories where much quicksilver is employed, together with a high temperature, is very prejudicial to health; but we can in a great measure protect ourselves against it by placing all about open vessels containing fresh liver of sulphur.
To chemistry we are indebted for all these protective means against poisonous vapours, after we had discovered, by means of chemistry, the exact nature of these exhalations.
But it is quite another thing with the contagious exhalations from dangerous fevers and infectious diseases. They are so subtle that chemistry has never yet been able to subject them to analysis, and consequently has failed to furnish an antidote for them. Most of them are not catching at the distance of a few paces in the open air, not even the plague of the East; but in close chambers these vapours exist in a concentrated form and then become injurious, dangerous, fatal, at a considerable distance from the patient.

Now as we know of no specific antidotes for the several kinds of contagious matters, we must content ourselves with general prophylactic means. Some of these means are sometimes in the power of the patient, but most of them are solely available by the nurse, the physician, and the clergyman, who visit the sick.
As regards the former of these, the patient, if not too weak, may change his room and his bed every day, and the room he is to occupy may, before he comes into it in the morning, be well aired by opening the doors and all the windows. If he have curtains to his bed he may draw them to, and let the fresh air circulate once more through his room, before the physician or clergyman comes to visit him.
The hospitals used by an army in a campaign, which are often established in churches, granaries, or airy sheds, are for that reason much less liable to propagate contagion, and also much more beneficial for the patients than the stationary hospitals, which are often built too close, low, and angular. In the latter, the nurses, physicians, and clergymen often run great risks. And what risks do they not constantly run in the half underground damp dwellings of the lowest class of the people, in the dirty cellars of back courts and narrow lanes that the sun’s reviving rays never shine in, and the pure morning air never reaches, stuffed full with a crowd of pauper families, where pale care, and whining hunger seem for ever to have established their desolating throne!
During the prevalence of contagious diseases the poisonous qualities of the vitiated air are concentrated in such places, so that the odour of the pest is plainly perceptible, and every time the door is opened, a blast of death and desolation escapes. These are the places fraught with greatest danger to physician and clergyman. Is there any mode whereby they can effectually protect their lungs from the Stygian exhalation, when the crying misery on all sides appeals to them, shocks them, and makes them forgetful of self? And yet they must try to discover some preventive! How are they to do so?
I have said above, that we may gradually accustom ourselves to the most poisonous exhalations, and remain pretty well in the midst of them.
But, as is the case with accustoming ourselves to every thing, the advance from one extreme to the other must be made with the utmost caution, and by very small degrees, so it is especially with this.

We become gradually accustomed to the most unwholesome prison cells, and the prisoners themselves with their sighs over the inhuman injustice of their lot, often, by their breathing and the exhalations from their bodies, gradually bring the few cubic feet of their atmosphere into a state of such pestilential malignity, that strangers are not unfrequently struck down by the most dangerous typhoid fevers, or even have suddenly died by venturing near them, whilst the prisoners themselves, having been gradually accustomed to the atmosphere, enjoy a tolerable health.
In like manner we find that physicians who see patients labouring under malignant fevers rarely and only occasionally, and clergymen whose vocation only requires them to pay a visit now and then, are much more frequently infected than those who visit many such cases in a day.
From these facts naturally proceeds the first condition for those who visit such sick-beds for the first time, “that they should in the commencement rather see their patients more frequently, but each time stay beside them as short a time as possible, keep as far away as possible from the bed or chamber utensil, and especially that they should take care that the sick room be thoroughly aired before their visit.”
After these preliminary steps have been taken with proper caution and due care, we may then, by degrees, remain somewhat longer, especially beside patients with the slighter form of the disease, and of cleanly habits, we may also approach them sufficiently close to be able to feel their pulse and see their tongue, taking the precaution when so near them, to refrain from breathing. All this can be done without any appearance of affectation, anxiety, or constraint.
I have observed, that it is usually the most compassionate, young physicians, who, in epidemics of this sort, are soonest carried off, when they neglect this insufficiently known precaution, perhaps from excessive philanthropy and anxiety about their patients; that on the other hand, the hard hearted sort of every-day doctors who love to make a sensation by the large number of patients they visit daily, and who love to measure the greatness of their medical skill by the agility of their limbs and their rapidity, most certainly escape infection. But there is a wise middle path (which young clergymen who visit the sick are counselled to adopt), whereby they may unite the most sensitive and warmest philanthropy with immunity to their own precious health.

The consideration “that a precipitate self-sacrifice may do them harm but cannot benefit the patient, and that it is better to spare one’s life for the preservation of many, than to hazard it in order to gratify a few,” will make the above first precaution acceptable, viz.-by very gradually approaching and accustoming ourselves to the inflammatory material of the contagion, to blunt by degrees our nerves to the impression of the miasm (morbid exhalation) otherwise so easily communicable. We must not neglect to impress the same precautionary measures on the attendants of the sick person.
The second precaution is “that we should, when visiting the patient, endeavour to maintain our mind and body in a good equilibrium.” This is as much as to say, that during this occupation we must not permit ourselves to be acted on by debilitating emotions; excesses in venery, in anger, grief and care, as also over-exertion of the mind of all sorts, are great promoters of infection.
Hence to attend either as physician or clergyman a dear friend sick of the prevalent fever is a very dangerous occupation, as I have learnt from dear-bought experience.
We should endeavour moreover to preserve as much as possible our usual mode of living, and whilst our strength is still good we should not forget to take food and drink in the usual manner, and duly apportioned to the amount of hunger and thirst we may have. Unusual abstinence or excess in eating and drinking should be carefully avoided.
But in this respect no absolute dietetic rules can be laid down. It has been said that one should not visit patients when one’s stomach is empty, but this is equally erroneous as if it were to be said, one should visit them with an empty stomach. One who like myself is never used to eat anything in the forenoon, would derange his digestion and render himself more susceptible of infection were he, following the old maxim, to eat something for which he had no appetite and visit his patients in this state; and vice versa.
On such occasions we should attend more than ordinarily to our desires for particular articles of diet, and procure if possible that for which we have most appetite, but then only eat as much as will satisfy us.
All over fatigue of the body, chills and night-watchings, should be avoided.

All over fatigue of the body, chills and night-watchings, should be avoided.
Thus we become gradually habituated to the occupation of tending patients suffering from malignant fevers, which is fraught with so much danger and cannot be compensated by any amount of pecuniary remuneration, until at length it becomes almost as difficult to be infected at all as to get the small-pox twice. If under all these circumstances we retain our courage, sympathizing compassionate feelings, and a clear head, we become persons of great importance in the state, not to be recompensed by the favour of princes, but conscious of our lofty destiny and rising superior to ourselves, we dedicate ourselves to the welfare of the very lowest as well as the highest among the people, we become as it were angels of God on earth.
Should the medical man experience in himself some commencing signs of the disease, he should immediately leave off visiting the patient, and if he have not committed any dietetic or regiminal error, I would recommend, notwithstanding I have endeavoured in this book to avoid anything like medicinal prescriptions, the employment of a domestic remedy, so to speak, empirically.
In such cases I have taken a drachm of cinchona bark in wine every three quarters of an hour, until all danger of infection (whatever kind of epidemic fever the disease might be) was completely over.
I can recommend this from my own experience, but am far from insisting upon the performance of this innocuous and powerful precaution by those who are of a different opinion. My reasons would be satisfactory if I could adduce them in this place.
But as it is not enough to protect ourselves from infection, but also necessary not to allow others to come in the way of danger through us, those who have been engaged about such patients should certainly not approach others too nearly until they have changed the clothes they had on when beside the patients for others, and the former should be hung up in an airy place where no one should go near them, until we again need them to visit our patients. Next to the sick-room, infection takes place most easily by means of such clothes, although the person who visits the patient may not have undergone any infection.
A highly respectable and orderly individual who for years had never walked anywhere, but only to his office at the fixed hours, had a female attendant with whom he was on very friendly terms, an old good-natured person, who without his knowledge employed all her leisure hours in making herself useful to a poor family living about a hundred yards from his house, who were lying sick of a putrid fever, the prominent character of which was, a malignant typhoid fever. For a fortnight all went on well; but about this time the gentleman received some intelligence of a very annoying and depressing character, and in a few days, although to my certain knowledge he had seen no one affected with such a disease, he got, in all probability from the clothes of his attendant who was often very close to him, exactly the same kind of malignant fever, only much more malignant. I visited him as a friend with unreserved sympathy as I ought, and I fell sick of the same fever, although I had been already very much accustomed to infection.

This case, together with many other similar ones, taught me that clothes carry far and wide the contagious matter of such fevers, and that depressing mental emotions render persons susceptible to the miasm, even such as are already used to its influence.
It would appear that the lawyer who draws up a will, the notary and the witnesses would, on account of not being habituated to such impressions, run much greater risk of being infected in these cases. I do not deny it; but for them there are modes of escape which are not so accessible to the other persons of whom we have spoken.
Where there is nothing, the sovereign has lost his rights, there is no will to be made. But when wealthy persons wish to make their last will and testament on their sick bed, there are two circumstances in favour of the lawyer and his assistants. As in the formalities of a legal testament, the patient’s bed often cannot remain in its usual situation, and as moreover it is essential for such a testament that the testator should be in full possession of his intellectual faculties, it follows that for those patients who are not absolutely poor another room and another bed may be got ready, thoroughly aired and free from infectious atmosphere. They do not need to remove thither until all this has been properly performed a short time before.
The weakness of the intellect in such patients generally keeps pace with their corporeal weakness, and a patient who possesses sufficient strength of intellect to make his will would not allege that he is too weak to be removed to another bed and room.

How little chance there is of the legal officials catching the infection under these circumstances (provided they take moderate care not to approach the patient nearer than necessary), I need not dwell upon.
I should mention that after one has once accustomed himself to any particular kind of miasm, for example the bloody flux, the nerves remain for a considerable time, often for years, to some degree insensible to the same kind of disease, even though during all that time we may have had no opportunity of seeing patients affected with that disease, and thus as it were of keeping the nerves actively engaged in keeping up this state of specific unsusceptibility. It gradually goes off, but more slowly than one would suppose. Hence with moderate precaution a nurse, a physician, or a clergyman, may attend dysenteric patients this year if they have had to do with similar patients several years previously. But the safest plan is to employ even in this case a little blameless precaution.
But as the superstitious amulets and charms of our ancestors’ times did harm, inasmuch as full credit was given to their medicinal virtues, and better remedies were consequently neglected, so for like reasons the fumigations of the sick room with the vapour of vinegar, juniper-berries and the like, is inadvisable, although the majority of my colleagues highly recommend it, and assert that the most infectious miasms of all kinds have thereby been overpowered and driven away, and thus the air purified.
Being convinced of the contrary, I must directly contradict them, and rather draw upon myself their disfavour than neglect an opportunity of rendering a service to my fellow-creatures. But as the spoiled (phlogisticated, foul, fixed, andc.) air can never be restored to purity or turned into vital air by means of these fumes, and as there is not a shadow of a proof that the subtle contagious exhalations, whose essential nature is quite unknown to us and not perceptible to our senses, can be weakened, neutralized, or in any other manner rendered innocuous by these fumes, it would be foolish, I would almost say unjustifiable, by recommending such fumigations for the supposed purification of the air, to encourage ordinary people in their natural indolence and indisposition to renew the air of their apartments, and thereby expose every different person who comes in contact with them to a danger to his life, which shall be all the more obvious and great, the more confident he has been made by the futile representation that, without driving away the disease-spreading miasm by means of repeated draughts of air, the pestilential atmosphere of the sick room has been converted into pure healthy air by means of simple fumigations with vinegar and juniper berries. That is just like the old superstition of hanging an eagle-stone at the hip of the woman in labour, at the very moment when all hopes of saving her, even by the forceps, are over.

When a physician or clergyman enters an unfumigated chamber he can at once tell by his sense of smell whether his needful order to air the room has been obeyed or not. All sick people make a disagreeable smell about them. Therefore the freedom from smell of a chamber is the best proof that it has previously been aired, but if fumigations have been had recourse to, the latter becomes doubtful and suspicious. Neither the physician nor the clergyman, neither the sick-nurse nor the patient, require perfumes when they have to think and speak seriously concerning a matter of life and death. They should never be used!

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Some history of the treatment of epidemics with Homeopathy – Julian Winston

 

From its earliest days, homeopathy has been able to treat epidemic 
diseases with a substantial rate of success, when compared to 
conventional treatments.  It was these successes that placed the 
practice of homeopathy so firmly in the consciousness of people
world-wide.

There is a story told about Joseph Pulte, one of the earliest homeopaths 
in Cincinnati.  When he began his practice, many people were so angered 
by a homeopath being in town that they pelted the house with eggs.  He 
was becoming discouraged enough to think of leaving.  His wife said, 
“Joseph, do you believe in the truth of homeopathy?” He replied in the 
affirmative.  “Then,” she said, “you will stay in Cincinnati.”

Shortly after, when the Cholera epidemic swept through, Pulte was able 
to boast of not having lost a single patient– and he was accepted into 
the community.  In the Epidemic of 1849, people crowded to his door and 
stood in the street because the waiting room was full.

In 1900, Thomas Lindsley Bradford, MD, wrote a book called “The Logic of 
Figures” in which he collected the statistics he could find that would 
compare the conventional therapeutics with homeopathic ones.
Many of the figures cited below are derived from Bradford’s work.

One of the earliest tests of the homeopathic system was in the treatment 
of Typhus Fever (spread by lice) in an 1813 epidemic which followed the 
devastation of Napoleon’s army marching through Germany to attack 
Russia, followed by their retreat.  When the epidemic came through 
Leipzig as the army pulled back from the east, Samuel Hahnemann, the 
founder of homeopathy, was able to treat 180 cases of Typhus– losing 
but two.  This, at a time when the conventional treatments were having a 
mortality rate of over 30%.

In 1830 as the cholera epidemic was reported coming from the east, 
Hahnemann was able to identify the stages of the illness, and predict 
what remedies would be needed for which stages.

When Cholera finally struck Europe in 1831 the mortality rate (under 
conventional treatment) was between 40% (Imperial Council of Russia)
to 80% (Osler’s Practice of Medicine).  Out of five people who 
contracted Cholera, two to four of them died under regular treatment.
Dr.  Quin, in London, reported the mortality in the ten homeopathic 
hospitals in 1831-32 as 9%; Dr.  Roth, physician to the king of Bavaria, 
reported that under homeopathic care the mortality was 7%; Admiral 
Mordoinow of the Imperial Russian Council reported 10% mortality under 
homeopathy; and Dr.  Wild, Allopathic editor of Dublin Quarterly 
Journal, reported in Austria, the Allopathic mortality was 66% and the 
homeopathic mortality was 33% “and on account of this extraordinary 
result, the law interdicting the practice of Homeopathy in Austria was 
repealed.”

Homeopathy continued to be effective in the treatment of Epidemic 
Cholera.  In 1854 a Cholera Epidemic struck London.  This was a 
historically important epidemic in that it was the first time the 
medical community was able to trace the outbreak to a source (a public 
water pump), and when the pump was closed, the epidemic soon ceased.
The House of Commons asked for a report about the various methods of 
treating the epidemic.  When the report was issued, the homeopathic 
figures were not included.  The House of Lords asked for an explanation, 
and it was admitted that if the homeopathic figures were to be included 
in the report, it would “skew the results.” The suppressed report 
revealed that under allopathic care the mortality was 59.2% while under 
homeopathic care the mortality was only 9%.

It is hard today to comprehend what kind of scourge such an epidemic 
was.  As was seen in the later Flu Epidemic of 1918, one could be 
healthy in the morning and be dead by evening– it moved that rapidly.
Many books were written about the Homeopathic treatment of Cholera 
during these times, among them: Cholera and its Homeopathic treatment, 
F.  Humphreys (1849); Homeopathic Treatment of Cholera, B.F.  Joslin 
(1854); Homeopathic Domestic Treatment of Cholera, Biegler (1858); 
Epidemic Cholera, B.  F.  Joslin (1885); Asiatic Cholera, Jabez Dake 
(1886).

The success of homeopathic treatment continued with the later cholera 
epidemics.  In the Hamburg epidemic of 1892, allopathic mortality was 
42%, homeopathic mortality was 15.5% During the 1850s, there were 
several epidemics of Yellow Fever in the southern states.  This disease 
was eventually found to be transmitted by mosquito.  Osler, says that 
the allopathic mortality from Yellow Fever is between 15-85%.  Holcome, 
a homeopath, reported in 1853 a mortality of 6.43% in Natchez, and Dr. 
Davis, another homeopath in Natchez, reported 5.73%.  In 1878 the 
mortality in New Orleans was 50% under allopathic care, and 5.6% (in 
1,945 cases in the same epidemic) with homeopathic care.

The two best books on this topic were: Yellow Fever and its Homeopathic 
Treatment, Holcome, (1856) and The Efficacy of Crotalus Horridus in 
Yellow Fever, C.  Neidhard, (1860).

Another epidemic disease which was treatable with homeopathy was 
Diphtheria.  Since the advent of widespread vaccination, it is a disease 
not often seen in our modern world.  Diphtheria appeared periodically, 
and rarely had the same presentation.  It was, therefore, very important 
for the practitioner to individualize the treatment in each specific 
case or generalized epidemic.  A remedy which had been effective in 
treating it one year might not be the same remedy needed the next year.

In the records of three years of Diphtheria in Broome County, NY from 
1862 to 1864, there was a report of an 83.6% mortality rate among the 
allopaths and a 16.4% mortality rate among the Homeopaths.  (Bradford)

Perhaps the most recent use of homeopathy in a major epidemic was during 
the Influenza Pandemic of 1918.  The Journal of the American Institute 
for Homeopathy, May, 1921, had a long article about the use of 
homeopathy in the flu epidemic.  Dr.  T A McCann, from Dayton, Ohio 
reported that 24,000 cases of flu treated allopathically had a mortality 
rate of 28.2% while 26,000 cases of flu treated homeopathically had a 
mortality rate of 1.05%.  This last figure was supported by Dean W.A. 
Pearson of Philadelphia (Hahnemann College) who collected 26,795 cases 
of flu treated with homeopathy with the above result.

The most common remedy used was Gelsemium, with occasional cases needing 
Bryonia and Eupatorium reported. Dr.  Herbert A.  Roberts from Derby, 
CT, said that 30 physicians in Connecticut responded to his request for 
data.  They reported 6,602 cases with 55 deaths, which is less than 1%. 
 Dr.  Roberts was working as a physician on a troop ship during WWI. He 
had 81 cases of flu on the way over to Europe.  He reported, “All 
recovered and were landed. Every man received homeopathic treatment. One 
ship lost 31 on the way.”

Closer to our present time, there were the Polio epidemics in the 
mid-1950s.  Dr.  Alonzo Shadman, a homeopath in the Boston area, 
emphasized that until *actual paralysis* was observed, it was hard to 
distinguish the prodromal symptoms of Polio from those of the common 
cold– and he treated many “summer colds” during the time.  Were they 
incipient polio?  No one can tell.

Dr.  Francisco Eizayaga or Argentina, tells of a polio epidemic in 
Buenos Aires in 1957, where the symptoms of the epidemic resembled those 
of the remedy Lathyrus sativa.  The homeopathic doctors and pharmacies 
prescribed Lathyrus 30c as a prophylactic, and “thousands of doses” were 
distributed.  “Nobody registered a case of contagion.”
Eizayaga points out that in other epidemics of polio, Gelsemium was the 
indicated remedy– emphasizing, again, the need for individualization.

Homeopathy has been very effective in treating many of the epidemics 
during the 19th and early 20th centuries.  Why the successes are not 
better known is a subject for conjecture.  It could be that, like the 
physician quoted below, most would rather not see the ineffectiveness of 
the conventional therapeutics nor accept the efficacy of homeopathy.
 From “Homeopathy In Influenza-A Chorus Of Fifty In Harmony” by W.  A.
Dewey, MD (Journal of the American Institute of Homeopathy, May 1921):

One physician in a Pittsburgh hospital asked a nurse if she knew 
anything better than what he was doing, because he was losing many 
cases.  “Yes, Doctor, stop aspirin and go down to a homeopathic 
pharmacy, and get homeopathic remedies.” The Doctor replied: “But that 
is homeopathy.” “I know it, but the homeopathic doctors for whom I have 
nursed have not lost a single case.”–W.  F.  Edmundson, MD, Pittsburgh.

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Cause and prevention of the Asiatic cholera – Hahnemann, 1831

 

A receipt has been given to the world, which proved so efficacious in Dünaburg in the Asiatic cholera, that of ten patients but one died. The chief ingredient is camphor, which is in ten times the proportion of the other ingredients. But not a tenth-nay, not one in a hundred of the patients would have died had the other ingredients, which were but injurious and obstructing, and the venesection been left out, and the camphor been given alone, and always at the very commencement of the disease, for it is only when given alone, and at the first invasion of the disease that it is so marvellously useful. But if physicians come, as usual, too late to the patient, when the favourable time for employing the camphor is past, and the second stage has already set in, when camphor is useless, then they may use it in vain; their patients will die under its employment. Hence every one, the instant any of his friends take ill of cholera, must himself immediately treat them with camphor, and not wait for medical aid, which, even if it were good, would generally come too late. I have received many communications from Hungary from non-medical persons, who have restored their friends, as if by magic, by giving camphor the instant they became ill.

Where the cholera first appears, it usually comes on in the commencement in its first stage (with tonic spasmodic character); the strength of the patient suddenly sinks, he cannot stand upright, his expression is altered, the eyes sunk in, the face bluish and icy cold, as also the hands, with coldness of the rest of the body; hopeless discouragement and anxiety, with dread of suffocation, is visible in his looks; half stupified and insensible, he moans or cries in a hollow, hoarse tone of voice, without making any distinct complaints, except when asked; burning in the stomach and gullet, and cramp-pain in the calves and other muscles; on touching the precordial region he cries out; he has no thirst, no sickness, no vomiting or purging.
In the first stage camphor gives rapid relief, but the patient’s friends must themselves employ it, as this stage soon ends either in death or in the second stage, which is more difficult to be cured, and not with camphor. In the first stage accordingly, the patient must get, as often as possible (at least every five minutes) a drop of spirit of camphor (made with one ounce of camphor to twelve of alcohol), on a lump of sugar or in a spoonful of water. Some spirit of camphor must be taken in the hollow of the hand and rubbed into the skin of the arms, legs, and chest of the patient; he may also get a clyster of half a-pint of warm water, mingled with two full teaspoonfuls of spirit of camphor, and from time to time some camphor may be allowed to evaporate on a hot iron, so that if the mouth should be closed by trismus, and he can swallow nothing, he may draw in enough of camphor vapour with his breath.

The quicker all this is done at the first onset of the first stage of the disease, the more rapidly and certainly will the patient recover; often in a couple of hours, warmth, strength, consciousness, rest and sleep return, and he is saved.
If this period of the commencement of the disease, so favourable to recovery and speedy cure, by the above indicated employment of camphor, has been neglected, then things look worse; then camphor is no longer serviceable. There are moreover cases of cholera, especially in northern regions, where this first stage, with its tonic spasmodic character, is hardly observable, and the disease passes instantly into the second stage of clonic spasmodic character; frequent evacuation of watery fluid, mixed with whitish, yellowish, or reddish flakes, and, along with insatiable thirst and loud rumbling in the belly, violent vomiting of large quantities of the same fluid, with increased agitation, groaning and yawning, icy coldness of the whole body, even of the tongue, and marbled blue appearance of the arms, hands and face, with fixed sunken eyes, diminution of all the senses, slow pulse, excessively painful cramp in the calves, and spasms of the limbs. In such cases the administration of a drop of camphor spirit every five minutes, must only be continued so long as decided benefit is observable (which with a remedy of such rapid action as camphor, manifests itself within a quarter of an hour). If in such cases decided benefit is not soon perceived, then no time must be lost in administering the remedy for the second stage.

The patient is to get one or two globules of the finest preparation of copper (prepared from metallic copper in the mode described in the second part of my work on Chronic Diseases), thus cuprum 0,00 X, moistened with water, and introduced into his mouth every hour or every half-hour, until the vomiting and purging diminish, and warmth and rest are restored. But nothing else at all must be given beside; no other medicine, no herb tea, no baths, no blisters, no fumigation, no venesection, andc., otherwise the remedy will be of no avail. Similar good effects result from the administration of as small a portion of white hellebore (veratrum album, 0,00 X); but the preparation of copper is much to be preferred, and is more serviceable, and sometimes a single dose is sufficient, which is allowed to act without a second being given, as long as the patient’s state goes on improving.
The wishes of the patient of all kinds are only to be indulged in moderation. Sometimes, when aid is delayed many hours, or other and improper remedies have been administered, the patient falls into a sort of typhoid state, with delirium. In this case, bryonia 00 X, alternately with rhus tox. 00 X, proves of eminent service.
The above preparation of copper, together with good and moderate diet, and proper attention to cleanliness, is the most certain preventive and protective remedy; those in health should take, once every week, a small globule of it (cupr. 0 X) in the morning fasting, and not drink anything immediately afterwards, but this should not be done until the cholera is in the locality itself, or in the neighbourhood. The health of the individual will not be in the least disturbed by this dose. I shall not, but any other homoeopathic practitioner may, tell where the above medicines may be procured, excepting the camphor, which, like the alcohol, may be had at every chemist’s shop.
Camphor cannot preserve those in health from cholera, but only the above preparation of copper; but when the latter is taken the vapour of camphor must be avoided, as it suspends the action of the copper.

Coethen, 10th September, 1831.

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The mode of propagation of the asiatic cholera – Hahnemann, 1831

 

Two opinions, exactly opposed to each other prevail on this subject. One party considers the pestilence as only epidemic, of atmospheric-telluric nature, just as though it were merely spread through the air, from which there would in that case be no protection. The other party denies this, and holds it to be communicable by contagion only, and propagated from one individual to another.
Of these two opinions one only can be the right one, and that which is found to be the correct one will, like all truths, exercise a great influence on the welfare of mankind.
The first has the most obstinate defenders, who adduce the fact that when the cholera has broken out at one extremity of the town, it may the very next morning be raging at the other extremity, consequently the infection can only be present in the air; and that they (the physicians) are in their own persons proofs of the non-contagious character of cholera, seeing that they generally remain unaffected by it and in good health, although they are daily in personal communication with those dying of cholera, and have even tasted the matter they ejected and the blood out of their veins, lain down in their beds, and so forth. This foolhardy, disgusting procedure they allege to be the experimentum crucis, that is to say, an incontrovertible proof of the non-contagious nature of cholera, that it is not propagated by contact, but is present in the atmosphere, and for this reason attacks individuals in widely distant places.

A fearfully pernicious and totally false assertion!
Were it the fact that this pestilential disease was uniformly distributed throughout the atmosphere, like the influenza that recently spread over all Europe, then the many cases reported by all the public journals would be quite inexplicable, where small towns and villages in the vicinity of the murderously prevalent cholera, which, by the unanimous efforts of all their inhabitants, kept themselves strictly isolated, like a besieged fortress, and which refused to admit a single person from without-inexplicable, I repeat, would be the perfect exemption of such places from the ravages of the cholera. This plague raged fiercely over an extensive tract on the banks of the Volga, but in the very middle of it, Sarepta, which had strictly and undeviatingly kept itself secluded, remained perfectly free from the cholera, and up to a recent period none of the villages around Vienna, where the plague daily carries off a large number of victims, were invaded by cholera, the peasants of these villages having all sworn to kill any one who ventured near them, and even to refuse to permit any of the inhabitants who had gone out of the villages to re-enter them. How could their exemption have been possible had the cholera been distributed throughout the atmosphere! And how easy it is to comprehend their freedom from it, seeing that they held aloof from contact with infected individuals.
The course followed by the cholera in every place it traversed was almost uniformly this: that its fury shewed itself most virulently and most rapidly fatal at the commencement of its invasion (evidently solely because at that time the miasm encountered none but unprepared systems, for which even the slightest cholera miasm was something quite novel, never before experienced, and consequently extremely infectious); hence it then infected persons most frequently and most fatally.
Thereafter the cases increased, and with them at the same time, by the communication of the inhabitants among each other, the quantity of diluted miasm, whereby a kind of local sphere of cholera-miasm exhalation was formed in the town, to which the more or less robust individuals had an opportunity of becoming gradually accustomed and hardened against it, so that by degrees always fewer inhabitants were attacked by it and could be severely affected by it (the cholera was then said to take on a milder character), until at last all the inhabitants were almost uniformly indurated against it, and thus the epidemic was extinguished in this town.

Did the miasm only exist in the general atmosphere, the cases could not be less numerous at last than they were at the commencement, for the same cause (said to be the general atmospheric constitution) must have remained identical in its effects.
The only fact brought forward by Hufeland against my proofs (viz., that on board an English ship in the open sea, about the latitude of Riga, that had had no (?) communication with the town, two sailors were suddenly seized with the cholera) proves nothing, for it is not known how near the ship came to the infected town, Riga, so that the sphere of the miasm-exhalation from the town, although diluted, might yet have reached and infected the sailors, who were still unused to the miasm, especially if they, as is often the case, were rendered more susceptible to it from intemperance.
The most striking examples of infection and rapid spread of cholera take place, as is well known, and as the public journals likewise inform us, in this way: On board ships-in those confined spaces, filled with mouldy watery vapours, the cholera-miasm finds a favourable element for its multiplication, and grows into an enormously increased brood of those excessively minute, invisible, living creatures, so inimical to human life, of which the contagious matter of the cholera most probably consists-on board these ships, I say, this concentrated aggravated miasm kills several of the crew; the others, however, being frequently exposed to the danger of infection and thus gradually habituated to it, at length become fortified against it, and no longer liable to be infected. These individuals, apparently in good health, go ashore, and are received by the inhabitants without hesitation into their cottages, and ere they have time to give an account of those who have died of the pestilence on board the ship, those who have approached nearest to them are suddenly carried off by the cholera. The cause of this is undoubtedly the invisible cloud that hovers closely around the sailors who have remained free from the disease, and which is composed of probably millions of those miasmatic, animated beings, which, at first developed on the broad marshy banks of the tepid Ganges, always searching out in preference the human being to his destruction and attaching themselves closely to him, when transferred to distant and even colder regions become habituated to these also, without any diminution either of their unhappy fertility or of their fatal destructiveness.

Closely but invisibly environed by this pestiferous, infectious matter, against which, however, as has been observed, his own individual system is, as it were, fortified by the long resistance of his vital force to its action, and by being gradually habituated to the inimical influence surrounding him, such a sailor (flying from the corpses of his companions on board) has often gone ashore apparently innocuous and well, and behold! the inhabitants who hospitably entertained him, and first of all those who came into immediate contact with him, quite unused to the miasm, are first most rapidly and most certainly attacked without any warning, and killed by the cholera, whilst of those who are more remote, such only as are unnerved by their bad habits of life are liable to take the infection. Those who are not debilitated, and who have kept at some distance from the stranger who is surrounded by the cholera miasm, suffered only a slight attack from the miasmatic exhalation hovering about in a more diluted form; their vital force could easily ward off the weaker attack and master it, and when they subsequently came nearer it their system had by this time become somewhat habituated to the miasm, retained the mastery over it, and even when these persons at length approached nearer or quite close to the infected stranger, their vital force had thus gradually become so fortified against it, that they could hold intercourse with him with perfect impunity, having now become completely uninfectable by the contagious principle of the cholera. It is a wonderfully benevolent arrangement of God that has made it possible for man to fortify himself against, and render himself unsusceptable to, the most deadly distempers, and especially the most fatal of them all, the infectious principal of cholera, if he gradually approaches it ever nearer and nearer, allowing intervals of time to elapse in order to recover himself, provided always be have an undebilitated body.
When first called to a cholera patient, the physician, somewhat timid as yet, as is but reasonable, either tarries at first in the antechamber (in the weaker atmosphere of the miasmatic exhalation) or if he enter the patient’s room prefers keeping at some distance, or standing at the door, orders the nurse in attendance to do this or the other to the patient, he then prudently soon takes his departure promising to return again shortly; in the meantime he either goes about a little in the open air, or goes home and has some refreshment. His vital force, which at the first short visit at some distance from the patient, was only moderately assailed by the diluted miasm, recovers itself completely in the meantime by this recreation, and when he again comes into the patient’s room and approaches somewhat nearer to the patient, it soon by practice comes to resist more powerfully the more concentrated infectious atmosphere that exists closer to the patient, until at length, from frequent visits and a nearer approach to the patient, it attains a mastery over the assaults of the miasm, so that at last the physician is completely hardened against even the most poisonous cholera miasm at the bedside, and rendered quite uninfectable by this pestilence; and the same is the case with the nurse who goes as cautiously and gradually to work.

Both the one and the other then boast, because they can come into immediate contact with the patient without any fear and without any ill consequences, that they know better than to call the disease contagious; it is not, they say, the least catching. This presumptuous, inconsiderate, and perfectly untrue assertion has already cost thousands their lives, who in their ignorance, and quite unprepared, either approached the cholera patient suddenly or came in contact with these cholera physicians (who do not treat with camphor) or the nurses. For such physicians and nurses, fortified in this manner against the miasm, now take away with them in their clothes, in their skin, in their hair, probably also in their breath, the invisible (probably animated) and perpetually reproductive contagious matter surrounding the cholera patient they have just visited, and this contagious matter they unconsciously and unsuspectingly carry along with them throughout the town and to their acquaintances, whom it unexpectedly and infallibly infects, without the slightest suspicion on their part of its source.
Thus the cholera physicians and nurses are the most certain and frequent propagators and communicators of contagion far and wide; and yet amazement is expressed, even in the public journals, how the infection can spread so rapidly the very first day, from the first cholera patient at the one end of the town to persons at the other end of the town, who had not come near the patient!
And thus the flame for the sacrifice of innocent persons breaks out in all corners and ends of the town, lighted up by the sparks of the black death scattered in every direction by physicians and their assistants! Every one readily opens the door to these plague-propagators; allows them to sit down beside him, putting implicit faith in their confidently declared assurance: “that it is ridiculous to call the cholera contagious, as the cholera pestilence is only diffused epidemically through the air, and cannot, therefore, be infectious”-and see! the poor cajoled creatures are rewarded for their hospitality with the most miserable death.

To the very highest people of the town and of the court the cholera angel of death obtains access, in the person of the physician who gives this evil counsel, enveloped by the fresh miasm; and no one detects the concealed, invisible, but, for that reason, all the more dangerous enemy.
Wherever such physicians and such nurses go (for what all-seeing eye could perceive this invisible danger on these healthy miasm-bearers?)-wherever they go, their presence communicates the spark, and mortal sickness bursts forth everywhere, and the pestilence depopulates whole towns and countries!
If physicians would but take warning, and, rendered uninfectable by taking a few drops of camphorated spirit, approach (ever so quickly) the cholera patient, in order to treat him at the commencement of his sickening with this medicine (pure, unadulterated camphorated spirit) which alone is efficacious, and which most certainly destroys the miasm about the patient, by giving him, as I have taught, every five minutes one drop of it, and in the interval assiduously rubbing him on the head, neck, chest, and abdomen with the same medicine poured into the hollow of the hand, until all his giddy faint powerlessness, his suffocative anxiety, and the icy-coldness of his body has disappeared, and given place to reviving animation, tranquillity of mind, and complete return of the vital warmth-if they would but do this, then every patient would not only be infallibly restored within a couple of hours (as the most undeniable facts and instances prove), but by the cure of the disease with pure camphor, they would at the same time eradicate and annihilate the miasm (that probably consists of innumerable, invisible living beings) in and about the patient, about themselves, even in the clothes, the linen, the bed of the patient (for these all would be penetrated by the vapour of the camphor if it were employed in this way) in the very furniture and walls of the apartment also, and they themselves (the physicians and nurses) would then carry off none of the contagious principle with them, and could no longer infect persons throughout the town.

But these physicians, as we see, despise this; they prefer going on killing their patients in crowds by pouring into them large quantities of aqua-fortis and opium, by blood-letting, and so forth, or giving the camphor mixed with so many obstructing and injurious matters, that it can scarcely do any good, solely to avoid giving the simple, pure (efficacious) solution of camphor, because the reformer of the old injurious system of treatment (the only one they know), because I, from conviction, recommended it in the most urgent manner in all countries of Europe. They seem to prefer delivering over all mankind to the grave-digger, to listening to the good counsel of the new purified healing art.
But who can prevent them acting so, as they alone possess the power in the state to suppress what is good?
However, bountiful Providence has provided a beneficent remedy for this state of things (for these physicians are protected, even in their ill-deeds, by antiquated injurious laws).
Thus, the cholera is most surely and easily and almost miraculously curable, but only in the first couple of hours from the commencement of the sickening, by means of the employment of pure camphor, and that before the physicians in larger towns that are summoned can attend. But on their arrival they may even then, by the employment of unadulterated camphor-spirit, if not cure the cholera completely (for the lapse of a few hours generally makes it too late to do so) yet annihilate the whole of the contagious principle of this pestilence on and about the patient, and adhering to themselves and the bystanders, and cease to convey the miasm with them to other parts of the town. Hence the families of non-medical persons, by means of this employment of camphor, cure the members of their families by thousands in secret (the higher classes alone, must, on account of their station, be under the necessity of calling in the physician, who, in defiance of the philanthropic reformer of the healing art, and his efficacious system of treatment, not unfrequently, with his improper remedies, dispatches them to Orcus).

It is members of a family alone that can most certainly and easily mutually cure each other with camphor spirit, because they are able instantaneously to aid those taken ill.
Will physicians ever come to comprehend what is essential, and what will at once put a stop to the devastation and depopulation of two quarters of the globe?
Dixi et salvavi animam!

  • Cöthen, the 24th October, 1831.
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Remedies Related to Pathological Tissue Changes

 

James Tyler Kent, The Homoeopathician, Journal for Pure Homoeopathy, No. 2. August 1912.

Provings of remedies are not continued to the extent of producing tissue alterations-indurations, infiltrations, suppuration, caries, etc. Most of the indications for the use of remedies in these conditions must be learned clinically; from the use of remedies in patients when these conditions have developed. When a remedy has been prescribed for a patient in whom tissue-changes have occurred, the prescription being based on the symptom-image, resolution of the existing tissue-changes has occurred, as a result of the reaction to the remedy. These become reliable clinical symptoms of the remedy: demonstrations of the power of the remedy over the altered tissue. These remedies are then recognised to be suited to constitutions in which these pathological changes can develop. Hence they are as important to the prescriber as though they had appeared actually in the proving.

In many instances such cure of pathology has occurred as a delightful surprise to the physician, who realizes in this evidence the accuracy of the prescription, which not only restored the functional activities but altered the nutrition to the extent of removing the products of disorder.

The difficulty in prescribing for patients with such altered tissue – cataract, hepatization (in pneumonia), induration of glands, arterio-sclerosis, fibroids, cancer, etc. – rests in the fact that when these tissue-changes occur, the symptoms on which a prescription should be based – the symptoms of the patient – have disappeared. The symptoms present at the time are symptoms of the pathology. If the symptoms that preceded this condition can be learned, and considered together with the later results of disorder – the pathological tissue – it may be possible to select a remedy that is sufficiently related to both the patient and his pathology, to effect a cure of both, provided always that the reaction and vitality of the patient are sufficient to permit the resolution.

Caust., Graph., Lyc., Nit-Ac., Staph., Thuja and many other remedies relate to excrescences. Skin indurations are met by Ant-C., Calc., Con., Lyc., Phos., Rhus., Sep., Sil., Sulph. and similar remedies. Indurated glands find suitable remedies in Ben-Ac., Brom., Calc., Calc-F. and remedies of similar depth, while such remedies as Caust., Bry., Con., Kali-C., and Lyc. are found suited to muscle indurations. 

Acon., Bapt., Gels., Ipec. and remedies of this scope have never been known to produce any alteration by induration and infiltration, hence the wise prescriber will not select these remedies for patients with the aforementioned conditions, when he has those, from which to select, which are preeminently related to the exact condition present. The final selection of a remedy, when these conditions are present, is to be determined by the character of symptoms that preceded, or what may be present and indicative of the patient himself.

In pneumonia, in hepatization period, when the symptoms point to Arsenicum, the patient will die if Arsenicum is prescribed, for this remedy is not deep enough to include that infiltration: Sulphur, Lycopodium, Phosphorus, Calcarea, etc., must take up the work where Arsenicum could not proceed. One of these remedies will clear out the lungs, in a few hours, with a disappearance of all the symptoms dependent upon the infiltration, and the patient, freed of the burden, will be restored to health promptly, instead of succumbing to the mechanical interference and consequent air-starvation.

In arterio-sclerosis, in cataract, in induration of liver or other glandular structures, the same principle holds. Ars., Bry., Puls. and other short and mediumly-short-acting remedies are insufficient because they have not power to take hold of this condition, while Silica, Calcarea Fluorica, Sulphur and such deep-acting remedies have been known to remove the tissue change by their deeper action, hence more similar, and from them one may be selected which will prove curative.

By reference to the repertory the prescriber may find remedies which have thus been established as suitable for suppuration, those suited for cancer, those suited for tuberculosis, those related to apoplexy, etc., and as an intelligent prescriber, the physician should select a remedy for the patient similar to the condition of the ultimated disorder. This is totally different from prescribing on the pathology alone, or seeking a specific for the name of the ultimate, regardless of the patient.

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Observations on the scarlet-fever (Hahnemann, 1808)

 

The malignant scarlet-fever that has prevailed in Germany for eight years and proved fatal to many thousands of children and older persons, often so unexpectedly, so rapidly, and with symptoms never before heard of under such circumstances, this murderous disease, termed scarlet-fever by almost every one, is really anything but scarlet-fever; it is a new disease never seen in Germany before the year 1800, which, on account of the red rash that usually accompanies it, might be termed purpura miliaris, and which, then for the first time, spread from the west, over Hesse, Bamberg, Beyreuth, Thuringia and Voigtland, to Saxony, and thence since that time has extended in all directions.

If it can be proved that this is a new disease and is widely different from the old genuine scarlet-fever (which old people can still very well remember to have noticed in their youth in themselves and others), we can very well understand how it happened, that the medical men did not know how to act in this new disease, and that at first all who were likely to die, slipped through their hands; indeed that their endeavours did more harm than good, as they were always under the delusion that they had to do with the old genuine scarlet-fever, and thus they were misled by this extraordinary confounding of names and things, to treat the new disease in the same way as they had been used to treat the true scarlet-fever (by means of keeping the patient warm, administering elder-flower tea, andc.). Such a mistake, such a confounding in diagnosis and treatment of two such very different diseases, must naturally have a very unfortunate result, as experience has shewn it to have had by the many thousands who have fallen victims to this new disease.

This disease is new among us, I repeat, for there is not the slightest trace of such a purple miliary fever having ever before prevailed in Germany.

The epidemic in Strasburg, described seventy-three years ago by Salzmann, was a white miliary fever-white vesicles on a white skin-and differed from our new miliary fever in this, that children and old people were almost entirely exempted from it, and it chiefly affected youths and adults between twenty and forty years of age; sore throat was very rarely met with in it.

The miliary epidemic described by Welsch, of Leipzig, 150 years ago, consisted of a white, millet-seed size dexanthema, and only affected lying-in women; probably it was a disease brought on by keeping them too warm.

The most recent miliary epidemic which Brüning observed thirty-six years ago, in the neighbourhood of the Lower Rhine, differs also from our new disease in this, that children of five years and under generally remained free from it, and women were more frequently attacked than men,-that it had its critical days, and was likewise a white miliary rash, resting for the first few days on red spots, which went off on the seventh day, leaving the white miliary rash standing from three to seven days longer on the white skin.

 The epidemics that bear the greatest resemblance to our present purple miliary, are those observed by David Hamilton, long ago (1710) in India, and Charles Allione (in 1758) in Turin.

 Other observers only mention having occasionally observed a miliary fever in single individuals, which were usually only brought on by the use of heating) diaphoretic remedies, especially of opiates, did not prevail epidemically, and are described by them in a most vague manner.

 That our miliary fever is new and very different from the true scarlet-fever, the following comparison will shew. 

The new red miliary-fever The old genuine scarlet-fever
attacks persons of all ages; attacks only children until their 12th year (Sim. Schulze)-attacks only children, almost never adults (Plenciz, Sennert);
the eruption consists of purple-red (Jani), of dark red spots (verging on brown), which on being pressed with the finger do not leave a white spot but remain unchanged, of a dark red colour, the redness of the skin is an erysipelatous fire-coloured redness (Sennert);-a bright scarlet redness, resembling erysipelas in colour and in this, that it immediately disappears on pressure with the finger and shews a white spot, which however immediately resumes its red colour (Navier); the redness is like the colour of a boiled lobster (Act. med. Berol.);-a cinnabar redness (Plenciz).
of sharply defined, discrete patches of redness, The smooth shining redness of the skin runs imperceptibly into the neighbouring white parts, in unnoticeable shades, like erysipelas, and is never well defined;-it becomes from time to time, now a little paler, now a little redder, and almost every instant it spreads imperceptibly farther, and then retires to its original seat (Navier).
Always thickly studded with dark-red miliary papulae, which are not so much elevated above the level of the skin as stuck deep in it, yet distinctly perceptible to both the eye and the touch. None of the above-mentioned authors allude to miliary elevations of the bright red parts of the skin;-the skin of the reddened parts is quite even and smooth (Hahnemann);-the red parts of the skin are quite smooth and destitute of inequalities or elevations (Plenciz, Op. tract. iii, p. 49)-and in this the scarlet-fever differs from every kind of miliary fever (Plenciz, ib., p. 58).
This exanthema attacks in an indeterminate manner, now this, now that part of the body-there is no part of the body for which it has a peculiar affection, or to which it attaches itself in a peculiar manner (Stieglitz). Most frequently the favourite spots for its attack are the covered parts and flexures of the joints; most rarely the face. The rash is usually accompanied by swelling (Stieglitz). The redness of the true scarlet-fever prefers attacking first the uncovered and but slightly covered parts, which swell as far as the redness extends. At first the redness and swelling occur on the face (De Gorter, Plenciz)-at first in the face, neck, and chest (Plenciz)-the scarlet redness first appears, with some swelling, on the face (neck and chest), the hands, and the outside of the feet and from these parts it spreads out in an erysipelatous manner (in the worst cases) all over the body (Hahnemann).
This exanthematous fever has not a determined, regular course, like other exanthematous fevers (Stieglitz);-the eruption remains here and there for an indeterminate period, often several weeks; there is no fixed period for its departure. In every genuine scarlet-fever the redness appears on the parts named simultaneously with the febrile heat, and in mild cases is perceptible for from three to four days (Plenciz, Sennert), in bad cases, seven days (Plenciz)-and goes off by becoming gradually paler from day to day. The parts that first became red, become first pale (Plenciz).
The red miliary rash often disappears suddenly at indeterminate times, with increased danger to life, usually followed suddenly by death. None of the above authors makes mention of the sudden disappearance of the redness of true scarlet fever during the fever. After the gradual fading of the redness up to the fixed days mentioned above, there occur apyrexia and desquamation (Sennert, Plenciz, De Gorter, Sim. Schulze). Even after death the hitherto red spots remain coloured and turn violet (Navier.
The eruption may be copious or almost not at all present, the mildness or malignancy of the disease not depending on that (Stieglitz). Where the eruption is almost imperceptible the danger is often greatest, the fever most malignant;-where there is a general full eruption, the disease is often mild and slight. The fuller and more extended the redness of true scarlet-fever is, the more malignant is the fever always (Hahnemann).
It is only the dark red miliary patches that perspire, and it is only when the whole body is covered with it that the patient perspires all over, as in the epidemic at Wittenberg None of the reddened parts in true scarlet-fever perspire during the disease (in all this the authors I have mentioned are agreed), if the skin is moist, it is so only on the parts that are not yet reddened. No erysipelas perspires, and as little does the scarlatina redness. It is only when the fever comes to an end, and the redness has gradually gone off, that there sometimes occurs general perspiration, and thereafter desquamation of the skin (Sim. Schulze), and the disease may also go off without any perspiration.-(Act. med. Beral.)
This new miliary disease, falsely said to be scarlet-fever, which first appeared about the middle of the year 1800, and, like every new pestilence, raged as a most murderous epidemic where it first appeared (there was no mild epidemic of it), and then from time to time recurred, often several times in a year in the same place (not unfrequently attacking the same persons a second time), during the first years still attacked several families in succession; during the last years did not, it is true, cease for any length of time, but did not prevail quite epidemically again, but rather attacked single families, or even single individuals, in one place (though it was not less fatal)-it seems in the course of a few years to have a tendency to become extinguished completely, like the English sweating-sickness at the commencement of the 16th century. The true scarlet-fever is an old disease, which has been accurately observed for two centuries in Germany and other countries, always appeared only as an epidemic and pandemic, always attacked indiscriminately, and with scarcely any exception, every child that had not had the disease (never those who had already had it), seldom prevailed in malignant, often in mild, sometimes in perfectly mild epidemics (Sydenham, De Gorter, Nenter, Junker), scarcely proving fatal to one child in a thousand, never, or very seldom, occurred sporadically, and the reason of this was, that as it almost always attacked pandemically all children who had not previously had it, there were not under 6 or 8 years enough subjects to infect in order to show its epidemic character, hence it almost never recurred in less than 6, 8, or 12 years, and on account of this rarity of its recurrence, the oldest practitioners scarcely ever saw it oftener than three times in their lives, and it was quite unknown to our younger practitioners.
Besides the diaphoretics, elder-flower tea, andc., and the warm beds wherewith it was sought to retain the eruption on the skin (usually without success), purgatives, especially mercurial medicines, are said to have done good in this exanethematous fever; but aconite, along with a moderately cool regimen saved the most. It were foolish to judge of the power of belladonna from its administration in this new miliary fever, which, as we see, is anything but scarlet-fever. In this old, true scarlet-fever, belladonna is useful, both as a prophylactic, and as a remedy.

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Cure and prevention of scarlet fever

 

(published as a pamphlet by Hahnemann in 1801)

Preface

Had I compiled a large book upon scarlet fever, I should have obtained, through the usual channels of publication, at least as much in the way of honorarium as by the subscription for this little book. But as, according to Callimachus, a great book is a great evil, and is soon laid aside, one of my chief aims, to wit, to excite a great interest in a subject of so much importance to humanity as this is, in order clearly to ascertain the truth, by bringing the observations of many to bear upon it-could not have been fulfilled so well by the large book as by the mode I have adopted.: 

Up to this period it is impossible that the corroboration of my assertion could be complete. The extract of belladonna, which I caused to be delivered to my subscribers, might have lost its power by the great distances it was sent, and by the long period it had been kept. Occasionally it fell into the hands of some who had neither the ability nor the good will to administer its solution in an appropriate manner. The precautions laid down in this book could not all be enumerated in a small paper of directions, where on account of the danger of misusing the medicine, it was necessary to direct that only the very smallest dose should be administered. Moreover it is probable, that the thorough admixture of the few drops with a sufficient quantity of the fluid in which it should be taken, was generally neglected; a circumstance the neglect of which makes this and every other medicine many hundred times less powerful than they would be were they properly combined with the diluting fluid. The hurry and inaccuracy of young doctors of the present day are well known, and we know also how little dependence we can place on our private patients.: 

In addition, very inclement weather, and in general what is understood a chill (which I have forgotten to allude to in the text), present obstacles by no means slight to the power of belladonna as a preventative of scarlet-fever. Children should be carefully preserved from it, without however completely excluding them from the open air, and if this precaution be neglected, the dose of the remedy should at all events be increased.: 

There may also be many other circumstances unknown to me to diminish the power of belladonna. The philanthropic physician ought to endeavour to discover and to avoid them.: 

It is only in accordance with my well known maxim (the new principle) that small-pox, to give one example from among many, has an important prophylactic in the cow-pox, which is an exanthematous disease, whose pustules break out after the sixth day of innoculation, with pain and swelling of the axillary glands, pain in the back and loins, and fever, and surrounded by an erythematous inflammation-that is to say, constituting altogether a disease very similar to variola. And, in like manner, a medicine which causes symptoms so similar to those of the invasion of scarlet-fever, as belladonna does, must be one of the best preventive remedies for this children’s pestilence. It should however be put to the test with candour, carefulness and impartiality-not cursorily or hurriedly, not with the design of depreciating the originator of it at the expense of truth.

But if its efficacious prophylactic power has incurred and may still incur opposition from prejudiced, ill-disposed, weak-minded and cursory observers, I may be allowed to appeal against their conduct to the more matured investigation of the clear-sighted, dispassionate portion of the public, and to trust to time for a just verdict. I should esteem myself happy if I should see, some years hence, this scourge of mankind in any measure diminished by my labours.

At the commencement of the year 1799 small-pox came from the neighbourhood of Helmstadt to Königslutter which spread slowly around, and though not mild in character, the eruption was small, warty looking, and accompanied with serious symptoms, especially of an atonic kind. In the village it came from, the scarlet fever was prevalent at the same time, and, mixed up with the latter, the small-pox made its appearance in Königslutter. About the middle of the year the small-pox ceased almost entirely, and the scarlet-fever then commenced to appear alone and more frequently.

In its main symptoms this epidemic of scarlet-fever resembled the scarlatina of Plenciz. In some families the disease was of a mild form, but generally it was of a bad kind.

When it occurred in the mild form it generally remained mild in the whole family living together. There occurred a slight feeling of weariness, a kind of faint-heartedness, some difficulty of swallowing, some fever, red face and hot hands. There then appeared, usually the very first day, alone with slight itching, the spots of various shape, and sometimes paler, sometimes redder, on the neck, the chest, the arms, andc., which disappeared again in from three to four days, and the desquamation that followed was scarcely observable on the fingers, and almost nowhere else. Towards evening only the patients laid down in bed for a short time, but the rest of the day they went about. The sleep was pretty tranquil, the bowels usually somewhat less open than when in health, the appetite usually not much diminished.

Very different was the course, of the bad form of scarlet-fever that prevailed in most families. Generally the seventh day after the infection had been communicated it broke out suddenly and unexpectedly, without any previous feeling of illness seldom was it that horrible dreams on the previous night served as a prelude to it. All at once there occurred an unusual timidity and fearfulness, rigour with general coldness, especially in the face, the hands and the feet, violent pressive headache, especially in the forehead, above the orbits. Pressure in the hypochondria, chiefly in the region of the stomach; in most cases there occurs a very unexpected attack of violent vomiting, first of mucus, then of bile, then of water recurring at intervals of from twelve to twenty-four hours, accompanied by an ever increasing weakness and anxiety, with trembling. The parotid and sub-maxilliary glands swell and become hard and painful, swallowing becomes very difficult, with shooting pains. After rigours that last from twelve to twenty-four hours, the body becomes excessively hot, accompanied with itching burning, the head, neck, hands (forearms) and feet (legs) are hottest, and swollen so as to present a shining appearance, which lasts to the end of the disease. (Almost every paroxysm of heat terminates in profuse sweat, which, however, only affects the rest of the body, but not the head, hands and feet.) On these swollen parts, but first in the pit of the throat, then on the arms and legs, there appear about the second day variously shaped cinnabar coloured spots of various sizes that readily grow pale on any slight chill; these spots are scarcely raised above the level of the skin, and are always accompanied by smarting, itching, burning; as the disease advances they spread-out into a connected, but less vivid redness. On the outburst of the eruption, the fever does not diminish; on the contrary, the greater the redness the more violent is the fever. In the meantime the sore-throat increases, swallowing becomes very painful, in the worst cases almost impossible. The interior of the mouth, the tongue and the palate are inflamed, very painful, raw, and as if ulcerated all over. In very bad cases the swelling of the cervical glands almost closes the jaws, and from between the teeth, which can be but slightly separated, there flows almost incessantly a very viscid and very fetid saliva, which can scarcely be expelled from the mouth in consequence of the tongue being so painful. In like manner, in the worst cases the lining membrane of the nose is ulcerated. At this period the voice becomes weak, suppressed and unintelligible, and respiration difficult. The taste in the mouth is putrid; the stools, which are usually rarely passed, have the odour of assafoetida. A drawing pain in the back and cutting bellyache are characteristic symptoms, which, together with pressive headache, in bad cases persist in alternation day and night, but in less dangerous cases only recur in the evening after sunset, along with increase of anxiety and timidity. In the very worst cases there are alternate paroxyms of agonising tossing about, raving, groaning, grinding of the teeth, floccitations, general or partial convulsions and comatose stupefaction or sopor, with half-shut eyes and head bent backwards. The urine, which is light-coloured, and the faeces, are passed involuntarily, and the patient sinks down to the bottom of the bed. The grumbling, complaining disposition increases from day to day. The smallest quantity of food, even in the slighter cases, perceptibly and immediately increases the anxiety, more than in any other disease.

From the fourth to the seventh day, if death do not ensue, the skin rises up, or rather the pores of the skin on the reddest places become elevated, especially about the neck and the arms, in small, close, pointed miliary vesicles (somewhat resembling goose’s skin), which at first, as the redness of the rest of the skin declines, appear extremely red, but afterwards, or when cold is applied, grow pale and at length quite white; they are however empty, and contain no fluid.

Neither the greater intensity nor the more general extension of the redness of the skin, nor yet the occurrence of these empty miliary vesicles, diminish the fever after the manner of a critical eruption; the former indeed is rather a sign of an increased intensity of fever which can only subside as this redness decreases.

The bad form of scarlatina lasts from nine to fourteen days, and the disgust at food lasts about the same time. As the appetite returns, the patient first wishes for fruit, then meat, he generally prefers pork.

During the fever, blood-red spots now and then appeared on the sclerotic; in some the cornea of one or both eyes was completely obscured; others (probably badly treated patients) were rendered imbecile.

At length the epidermis gradually peels off on the places where the redness appeared, and even where there was only burning itching without subsequent redness; on the hands and feet it comes off in large pieces, like pieces of a torn glove, but on the other parts only in larger or smaller scales. In one case the nails of the fingers and toes also fell off. The falling off of the hair only commenced some weeks or months after the fever; in one case it went the length of total baldness.

Among the after-sufferings the following were prominent: long-continued debility, a very disagreeable feeling in the back, as if it were asleep (narcosis), pressive headache, a painful sensation of constriction in the abdomen only felt on bending backwards, abscesses in the interior of the ear, ulceration of the lining membrane of the nose, ulcerated angles of the mouth, other spreading ulcers in the face and other parts of the body, and generally a great tendency of the whole skin to ulceration (unhealthy skin as it is termed). In addition to the above, a great hurriedness in speaking and acting, fits of sleepiness by day, crying out in sleep, shuddering in the evening, puffiness and earthy colour of the countenance, swelling of the hands, feet and loins, andc.

Any one who chooses may read for himself in the works of the various authors the infinity of medicines and modes of treatment invented for this disease (from blood-letting and leeches to bark, from gargles and clysters to blisters, from antispasmodic, derivative, antiseptic to refrigerant, resolvent, purgative, involvent, humectant, alexiteric, incitant, asthenic, and God knows what other ingenious modes of treatment) intended to meet the thousand imaginary indications. Here we often see the ne plus ultra of the grossest empiricism: for each single symptom a particular remedy in the motley, mixed, and repeated prescriptions; a sight that cannot fail to inspire the unprejudiced observer with feelings at once of pity and indignation!

For my own part, when summoned to cases of the fully developed disease (where there was no question of prevention or suppressing its commencement), I found I had to combat two different states of body that sometimes rapidly alternated with one another, each of which was composed of a convolute of symptoms.

The first: the burning heat, the drowsy stupefaction, the agonising tossing about with vomiting, diarrhoea, and even convulsions, was subdued in a very short time (at most an hour) by a very small quantity of opium, either externally by means of a piece of paper (according to the size of the child, from a half to a whole inch in length and breath) moistened with strong tincture of opium, laid upon the pit of the stomach and left there until it dries; or if there is no vomiting, internally, by giving a small quantity of a solution of opium.

For external use I employed a tincture formed by adding one part of finely pulverised crude opium to twenty parts of weak alcohol, letting it stand in a cool place for a week, and shaking it occasionally to promote the solution. For internal use, I take a drop of this tincture and mix it intimately with 500 drops of diluted alcohol, and one drop of this mixture likewise with other 500 drops of diluted alcohol, shaking the whole well. Of this diluted tincture of opium (which contains in every drop one five-millionth part of a grain of opium) one drop given internally was amply sufficient in the case of a child of four years of age, and two drops in that of a child of ten years, to remove the above state. It is unnecessary to repeat these doses oftener than every four or eight hours, in some cases not more than every twenty-four hours, and that sometimes only a couple of times throughout the whole fever, for which the more frequent or more rare occurrence of these symptoms must be our guide.

Where also, during the further progress of the disease, the same symptoms appeared accompanied by constipation of the bowels, opium so applied externally, or given internally in such doses, never failed to produce the desired effect. The result, by no means of a transient character, appeared at most in an hour, sometimes within a quarter of an hour, and just as rapidly from the external application as from the internal administration.

Larger doses than the above, occasion raving, hiccough, unappeasable peevishness, weeping, andc.-an array of factitious symptoms which, when they are not severe, disappear spontaneously in a few hours, or may be more speedily removed by smelling at a solution of camphor.

The second morbid condition that occurs in the course of this disease: the increase of fever towards evening, the sleeplessness, the total loss of appetite, the nausea, the intolerable lachrymose peevishness, the groaning, that is, the state where opium does and must do harm,-this state was removed in a few quarters of an hour by ipecacuanha.

For this end, immediately on the occurrence of this state, or during its persistence, I gave, according to the age of the child, ipecacuanha, either in substance in the dose of a tenth to half a grain in fine powder; or I employed the tincture prepared by digesting in the cold for some days one part of the powder with twenty parts of alcohol, of this one drop was mixed with a hundred drops of weak alcohol, and to the youngest children a drop of this last was given, but to the oldest ones ten drops were given for a dose.

I found these two remedies as indispensable as they were generally completely sufficient not only to ward off the fatal termination, but also to shorten, diminish and alleviate the scarlet-fever. I cannot imagine a more suitable mode of treatment, so rapid and certain in its results I found it.

As regards moral and physical accessory dietetic means in the treatment of a fully developed case of scarlet-fever, I would advise that we should try to dispel all fear by means of kind and cheering words, by nice little presents, by holding out hopes of a speedy recovery-and on the other hand, we should allow the patient a free choice of all kinds of drinks, and warmer or cooler coverings to suit his feelings. The patient’s own feelings are a much surer guide than all the maxims of the schools. We must only take care kindly to keep the patient from taking solid nutriment too soon, or in too great quantity during his convalescence.

But even under the most appropriate and certain medical treatment of developed scarlatina of a bad type there is always risk of death, of the most miserable death, and the amount of the countless sufferings of the patients is not unfrequently so great that a philanthropist must wish that a means could be discovered by which those in health might be protected from this murderous children’s pestilence, and be rendered secure from it, more especially as the virus is so extremely communicable that it inevitably penetrates to the most carefully guarded children of the great ones of the earth. Who can deny that the perfect prevention of infection from this devastating scourge, and the discovery of a means whereby this divine aim may be surely attained, would offer infinite advantages over any mode of treatment, be it of the most incomparable kind soever?

The remedy capable of maintaining the healthy uninfectable by the miasm of scarlatina, I was so fortunate as to discover. I found also that the same remedy given at the period when the symptoms indicative of the invasion of the disease occurs, stifles the fever in its very birth; and, moreover, is more efficacious than other known medicaments in removing the greater part of the after-sufferings following scarlatina that has run its natural course, which are often worse than the disease itself.

I shall now relate the mode in which I made the discovery of this specific preservative remedy.

The mother of a large family, at the commencement of July, 1799, when the scarlet-fever was most prevalent and fatal, had got a new counterpane made up by a semptress, who (without the knowledge of the former) had in her small chamber a boy just recovering of scarlet-fever. The first mentioned woman on receiving it, examined it and smelt it in order to ascertain whether it might not have a bad smell that would render it necessary to hang it in the open air, but as she could detect nothing of the sort, she laid it beside her on the pillow of the sofa, on which some hours later she lay down for her afternoon’s nap.-She had unconsciously, in this way only (for the family had no other near or remote connexion with scarlatina patients), imbibed this miasm.-A week subsequently she suddenly fell ill of a bad quinsy, with the characteristic shooting pains in the throat, which could only be subdued after four days of threatening symptoms.

Several days thereafter, her daughter, ten years of age, infected most probably by the morbific exhalations of the mother or by the emanations from the counterpane, was attacked in the evening by severe pressive pain in the abdomen, with biting itching on the body and head, and rigour over the head and arms, and with paralytic stiffness of the joints. She slept very restlessly during the night, with frightful dreams and perspiration all over the body, excepting the head. I found her in the morning with pressive headache, dimness of vision, slimy tongue, some ptyalism, the submaxillary glands hard, swollen, painful to the touch, shooting pains in the throat on swallowing and at other times. She had not the slightest thirst, her pulse was quick and small, breathing hurried and anxious; though she was very pale, she felt hot to the touch, yet complained of horripilation over the face and hairy scalp; she sat leaning somewhat forwards in order to avoid the shooting in the abdomen which she felt most acutely when stretching or bending back the body; she complained of a paralytic stiffness of the limbs with an air of the most dejected pusillanimity, and shunned all conversation; “she felt,” she said, “as if she could only speak in a whisper.” Her look was dull and yet staring, the eyelids inordinately wide open, the face pale, features sunk.

Now I knew only too well that the ordinary favourite remedies, as in many other cases, so also in scarlatina, in the most favourable cases leave everything unchanged, and therefore I resolved in this case of scarlet-fever just in the act of breaking out, not to act as usual in reference to individual symptoms, but if possible (in accordance with my new synthetical principle) to obtain a remedy whose peculiar mode of action was calculated to produce in the healthy body most of the morbid symptoms which I observed combined in this disease. My memory and my written collection of the peculiar effects of some medicines, furnished me with no remedy so capable of producing a counterpart of the symptoms here present, as belladonna.

It alone could fulfil most of the indications of this disease, seeing that in its primary action it has, according to my observations, a tendency to excite even in healthy persons great dejected pusillanimity, dull staring (stupid) look, with inordinately opened eyelids, obscuration of vision, coldness and paleness of the face, want of thirst, excessively small, rapid pulse, paralytic immobility of the limbs, obstructed swallowing, with shooting pains in the parotid gland, pressive headache, constrictive pains in the abdomen, which become intolerable in any other posture of the body besides bending forwards, rigour and heat of certain parts to the exclusion of others, e. g., of the head alone, of the arms alone, andc. If, thought I, this was a case of approaching scarlet-fever, as I considered was most probable, the subsequent effects peculiar to this plant-its power to produce synochus, with erysipelatous spots on the skin, sopor, swollen, hot face, andc.-could not fail to be extremely appropriate to the symptoms of fully developed scarlatina.

I now earnestly desired to be able if possible to preserve the other five children of the family perfectly free from infection. Their removal was impossible and would have been too late.

I reasoned thus: a remedy that is capable of quickly checking a disease in its onset, must be its best preventive; and the following occurrence strengthened me in the correctness of this conclusion. Some weeks previously, three children of another family lay ill of a very bad scarlet-fever; the eldest daughter alone, who, up to that period, had been taking belladonna internally for an external affection on the joints of her fingers, to my great astonishment did not catch the fever, although during the prevalence of other epidemics she had always been the first to take them.

This circumstance completely confirmed my idea. I now hesitated not to administer to the other five children of this numerous family this divine remedy, as a preservative, in very small doses, and, as the peculiar action of this plant does not last above three days, I repeated the dose every 72 hours, and they all remained perfectly well without the slightest symptoms throughout the whole course of the epidemic, and amid the most virulent scarlatina emanations from their sisters who lay ill with the disease.

In the mean time I was called in to attend in another family, where the eldest son was ill of scarlet-fever. I found him in the height of the fever, and with the eruption on the chest and arms. He was seriously ill, and the time was consequently past to give him the specific prophylactic remedy. But I wished to keep the other three children free from this malignant disease; one of them was nine months, another two years, and the third four years of age. The parents did what I ordered, gave each of the children the requisite quantity of belladonna every three days, and had the happiness to preserve these three children free from the pestilential disease, free from all its symptoms, although they had unrestricted intercourse with their sick brother.

And a number of other opportunities presented themselves to me where this specific preventive remedy never failed.

In order to prepare this remedy for preventing the infection of scarlet-fever, we take a handful of the fresh leaves of the wild belladonna (atropa belladonna, Linn.) at the season when the flowers are not yet blown; these we bruise in a mortar to a pap, and press the juice through linen, and immediately (without any previous purification) spread it out scarcely as thick as the back of a knife, on flat porcelain plates, and expose it to a draught of dry air, where it will be evaporated in the course of a few hours. We stir it about and spread it again with the spatula, so that it may harden in a uniform manner until it becomes so dry that it may be pulverized. The powder is to be kept in a well stopped and warmed bottle.

If we now wish to prepare from this the prophylactic remedy, we dissolve a grain of this powder (prepared from well preserved belladonna extract evaporated at an ordinary temperature) in one hundred drops of common distilled water, by rubbing it up in a small mortar; we pour the thick solution into a one-ounce bottle, and rinse the mortar and the pestle with three hundred drops of diluted alcohol (five parts of water to one of spirit), and we then add this to the solution, and render the union perfect, by diligently shaking the liquid. We label the bottle strong solution of belladonna. One drop of this is intimately mixed with three hundred drops of diluted alcohol by shaking it for a minute, and this is marked medium solution of belladonna. Of this second mixture one drop is mixed with two hundred drops of the diluted alcohol, by shaking for a minute, and marked weak solution of belladonna; and this is our prophylactic remedy for scarlet-fever, each drop of which contains the twenty-four millionth part of a grain of the dry belladonna juice.

Of this weak solution of belladonna we give to those not affected with scarlet-fever, with the intention to make them uninfectable by the disease,-to a child one year old, two drops (to a younger child one drop), to one two years old, three-to one three years old, four-to a child four years old (according to the strength of his constitution), from five to six,-to a five years old child, from six to seven,-to a six years old child, from seven to eight,-to a seven years old child, from nine to ten,-to an eight years old child, from eleven to thirteen,-to a nine years old child, from fourteen to sixteen drops; and with each successive year up to the twentieth, two drops more (from the twentieth to the thirtieth, not above forty drops)-a dose every seventy-two hours (well stirred for a minute with a teaspoon in any kind of drink) as long as the epidemic lasts, and four (to five) weeks thereafter.

Should the epidemic be very violent, it would be safer, if the children could bear it, to let the second dose be taken twenty-four hours after the first, the third dose thirty-six hours after the second, the fourth forty-eight hours after the third, and thereafter to let the subsequent doses be taken every seventy-two hours until the end, in order that the system may not at first be taken by surprise by the miasm.

This course of medicine does not disturb the health of the children. They may and indeed ought to follow the mode of life of healthy individuals, and keep to their usual drinks, food, and ordinary recreation and exercise in the open air, but they must take care to avoid excess in any of these things.

The only thing I must prohibit is the use of too much vegetable acid, of sour fruits, of vinegar, andc. The action of belladonna is thereby enormously increased, as my experience (contrary to the assertions of ancient writers) has taught me.

In case of the occurrence of such a case of the injurious and too violent action of belladonna (from this or any other cause), we should make use of its peculiar (according to my observations specific) antidote, opium, externally or internally, in doses similar to those I have above indicated, for the external or internal treatment of natural scarlatina.

There are, however, cases in which we are forced to give the above doses of belladonna oftener than every seventy-two hours. A delicate girl, three years of age, who was successfully using the belladonna as a preservative, in the above dose, beside her sister who had scarlet-fever, bruised her hand severely one day with the door of the room, and thereby fell into a mental and bodily condition so favourable to the reception of the infection, that, notwithstanding that she had taken the prophylactic the day before, she presented in a few hours all the signs of approaching scarlet-fever; but two drops of the weak solution of belladonna given immediately removed these symptoms just as quickly, without any further effects. From that time forward she took the medicine only every three days (as previously), and she remained quite free from the scarlet-fever and well.

We would therefore do well in the event of such sudden accession of violent mental depressions, occasionally, when requisite, to give one or two extra doses. We will also sometimes meet with children who possess naturally such timorous, tranquil dispositions, that in them the dose above indicated for children of their age will not suffice to protect them from scarlet-fever; the physician may therefore be allowed to increase it somewhat, and to stir the drops up with somewhat more fluid, and for a minute longer. I may observe, that it is scarcely credible how much this and every other medicine loses in power (so as even to be unserviceable for protecting from scarlet-fever), if we allow it to be licked simply and unmixed with anything from a spoon, or give it only on sugar, or, though dropping it into a fluid, administer it without stirring it well up with it. It is only by stirring, by brisk, long-continued stirring, that a liquid medicine obtains the largest number of points of contact for the living fibre, thereby alone does it become right powerful. But the well stirred dose should not be allowed to stand for several hours before it is administered. Water, beer, milk, and all such excipient fluids, when allowed to stand, undergo some decomposition, and thereby weaken the vegetable medicinal agent mixed with them, or even destroy it completely.

I would, moreover, advise that the medicine bottle should be locked up after every time of using it. I once saw a little girl of four years old fill up a medicine bottle with brandy, whence, as she confessed to me, she had previously drunk out all the medicine, which was also made with spirit and colourless. She had mounted on the table, had taken the bottle down from a high cupboard in the wall, and was about to fill it up with what she supposed to be a similar fluid, in order that her parents might not discover what she had done, when I entered the room.

Although a practitioner will seldom be so fortunate as to accomplish this extinction of the fever in question in its birth by means of belladonna, because it is not usual to send for him at the very beginning when the miasm attempts its first partial onslaught, and when uneasy dreams, paralytic stiffness of the limbs, pressive headache, rigour over one or other limb and over the head, constitute almost the only symptoms of the still feeble reaction of the system, yet it is a real fact, and, according to my by no means small experience, beyond all doubt, that it is capable of extinguishing the approaching fever with all its concomitant symptoms in the course of from twenty-four to forty-eight hours, and of restoring the previous state of health without the slightest bad consequences. To accomplish this object I found it best in this case to administer the half of the dose recommended above as a preventative every three hours, until all the symptoms had disappeared, and then to continue giving a full dose only every seventy-two hours in order to protect the patient from all further infection.I have, indeed, even in cases where there was already shooting pain and swelling of the cervical glands and increased heat of skin, that is, when a more considerable degree of natural reaction against the miasm was present, always succeeded in attaining my object by similar doses given at similar intervals of time, but I cannot recommend this practice to any practitioner who is not a most accurate observer, because should he chance to overlook symptoms of a more advanced stage that may be present, it must always remain a doubtful matter, whether, in such a case, by the addition of a new and powerful agent, the advanced disease would be suppressed and extinguished, or a tumultuous commotion be excited in the diseased system without any good result.

But least of all is it probable that our object would be attained by giving belladonna, and it is certainly not advisable to attempt it, if there are present greater heat, redness of face, great thirst, inability to leave the bed, vomiting and cinnabar-coloured eruption, in other words, fully developed scarlatina. It does not seem suited for administration in the height of the fever, just as Peruvian bark cannot be given in the middle of the hot stage of a paroxysm of intermittent fever with advantage or without producing a bad effect on the system.

On the other hand, belladonna displays a valuable and specific power in removing the after-sufferings remaining from scarlet-fever-an object that our forefathers, as we know, vainly strove to attain. Most medical men have hitherto regarded the consequences of scarlatina as at least as dangerous as the fever itself, and there have been many epidemics, where more died of the after-affections than of the fever.

The puffiness of the face, the swelling of the hands and feet, andc., the cachexy, the slow evening fever with shuddering, the stiffness of the limbs, the sense of constriction of the abdomen on holding the body erect, the formication and sleeping (narcosis) in the spine, the inflammation of the glands, the suppuration inside the ears, the ulcers on the face, on the lining membrane of the nose, at the angles of the mouth, andc., the extraordinary debility of the whole body, the sleepy, dull disposition, alternating with excessive hurry in talking and acting, the calling out in sleep, the pressive headaches, andc., will be specifically and rapidly removed by the same doses of this remedy as suffice (v. supra) for prophylactic purposes, or accordingly as the practitioner judges expedient by smaller or larger doses of it. Sometimes all that is required is to give the doses somewhat more frequently.

It is only in some particular cases, where the original disease was very violent, and advice has been sought for the after-sufferings too late, that I have witnessed what is termed the unhealthy skin, that is, the tendency to a solution of continuity in the solid parts, to ulceration, sometimes to such a degree, that belladonna is no longer of service. In such and other similar cases the most excellent remedy was the inspissated juice of the matricaria chamomilla, dried at a natural temperature in the air-of this a grain was first of all dissolved in 500 drops of water and mixed intimately with 500 drops of alcohol, and of this solution one drop was mixed with 800 drops of diluted alcohol-of this last diluted solution one drop (1/800000th of a grain of the inspissated juice) was given every day to a child of a few years old, two drops to one of ten years of age, and so forth; the medicine being well mixed with any liquid, and in a few days all tendency to ulceration of the skin was removed, the so-called unhealthy skin was cured-a disease in every case much dreaded by every medical man who does not know of this excellent but very heroic remedy.

The suffocating cough that sometimes follows the disease is also removed by chamomilla, especially if there is at the same time a tendency to flushing of the face, accompanied by horipilation over the limbs or back.Share this ...
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A Contribution to the Judgement Concerning The Characteristic Value of Symptoms (Boenninghausen, 1858)

 

BoenninghausenA Contribution to the Judgement Concerning The Characteristic Value of Symptoms (Boenninghausen, 1858)

It is now over three years since the great Homoeopathic Congress was held in Brussels, Germany being, I am sorry to say, but little represented. In the last session of this meeting after several propositions had been read, my resolution was adopted and a prize-question was proposed, to answer which a period of two years was granted. This prize essay, as the Homoeopathic journals have also made known, was intended to call out a “Treatise concerning the greater or lesser (characteristic) value of the symptoms occurring in a disease, to aid as a norm or basis in the therapeutical selection of the remedy.” The answer to this question was not limited to Belgium or to France, but it was handed over to the competition of the whole medical world, and it was thus unanimously acknowledged to be a subject of the greatest importance. Nevertheless, this question, in spite of the daily increase of the homoeopathic literature, has thus far remained unsolved. This silence extending far over the time set, which was computed liberally enough, seems to justify the assumption that the solution of the question has met with considerable difficulties, though every homoeopath must every moment find himself in the position to ask himself this question, and to have to answer it. It might not appear altogether proper for me, the author of the question, to also now enter among the competition for this prize. But the old practitioner will be pardoned for furnishing at least some contribution to the solution, and thereby again calling attention to the question.
The teaching of the Organon in this matter really contains the proper, true kernel of the answer, and this, of course, deserves to be first premised. It is found in the great Paragraph No. 153 (5th Ed.) and is as follows:
“In seeking for the specific homoeopathic remedy, i.e., in this juxtaposition of the phenomena of the natural disease and the list of symptoms of the medicines, in order to discover a morbid potency corresponding in similitude to the evil to be cured, the more striking, particular, unusual and peculiar (characteristic) signs and symptoms of the case should especially and almost solely be kept in view; for there must especially be some symptoms in the list of the medicine sought for corresponding to this, if the remedy should be the one most suitable to effect the cure. The more general and indefinite symptoms, such as lack of appetite, headache, weariness, disturbed sleep, uncomfortableness, etc., in their generalness and undefinedness deserve but little attention, unless they are more especially pronounced, as something of such a general nature is seen in almost every disease and in almost every medicine.”
It is seen, however, that it is here left to the physician to judge what is understood by the “more striking, particular, unusual and peculiar” symptoms, and it might, indeed, be difficult to furnish a commentary to this definition, which would not be too diffuse and, therefore, easily understood, and on the other hand would be complete enough to be properly applied to all these cases. Whence is it that we are unable to show any such definition in our literature? Even what Hahnemann adduces in §86, and those that follow, only contains some examples which are given without any systematic order, and are therefore but little suited to impress themselves on the memory, a requirement which in all such matters must appear to be of very great importance.
After looking about in the whole of the medical writings, allopathic as well as homoeopathic, for an aid, I remembered that in the middle ages they were accustomed to bring all such matters into the form of verses, in order that the memory might thus be assisted. The modern learned world knows, e.g., the diet of the Schola salernitana, dating from the beginning of the twelfth century, drawn up in leonine verses, as is supposed, by a certain John of Milan, from which some parts are quoted even to this day. But though I did not find here anything for the present purpose, I yet found something which, as it seemed, might prove useful with writers of quite a different doctrine. There is, namely, a hexameter dating from this same period but from the theologic scholastics; this is, indeed, of a somewhat jolting construction, nevertheless it contains briefly and completely the various momenta according to which a moral disease is to be judged as to its peculiarity and grievousness. The verse is the following:
“Quis? quid? ubi? quibus auxiliis? cur? quomodo? quando?”
The seven rubrics designated in this maxim seem to contain all the essential momenta which are required in the list of the complete image of a disease. May I be allowed, therefore, to attach my remarks to this scheme, with the desire that this hexameter, which was formerly used only by theologians, may now be also impressed on the memory of homeopaths and be put to use by them.

1. Quis?
As a matter of course the personality, the individuality of the patient, must stand at the head of the image of the disease, for the natural disposition rests on it.
To this belongs first of all the sex and the age; then the bodily constitution and the temperament; both, if possible, separated, according to his sick and his well days i.e., in so far as an appreciable difference has appeared in them. In all these peculiarities whatever differs little or not at all from the usual natural state needs little attention; but everything that differs in a striking or rare way therefrom deserves a proportionate notice.
The greatest and most important variations are here found mostly in the states of the mind and spirit, which must by scanned all the more carefully, if they are not only sharply distinct, but also of rare occurrence and, therefore, correspond to only few remedies. In all such cases we have all the more cause to fathom these states with all possible exactness, as in them frequently the bodily ailments recede to the background, and for this very reason offer but few points for our grasp, so that we may be able to make a sure selection among the remedies which compete.
Paragraph 104 of the Organon makes it a duty of the homoeopath to make a written scheme of the image of the disease, and whoever has once acquired a certain facility in this will easily know how to satisfy this requirement and gradually acquire a certain specializing penetration, which will prove to him of ever increasing usefulness. For as every man presents an individual nature different from every other one, and as every medicine must be exactly adapted to this individuality, in agreement with the symptoms, which it is able to produce in the total man, so, an once, at this first investigation as to the Quis? A great number of medicines are thrust aside, just because they do not correspond to the personality of the patient.
The spiritual and dispositional individuality of the patient here gives the most important, often almost the only deciding points for the selection of the remedy, where the disease involved is one of the mind or spirit, and generally the two disturbances present themselves so conjoined into one that the signs of the one only receive their full and definite character from the other. Hahnemann, indeed, recognized the importance of this two momenta from the beginning, but the necessity of weighting the two in their connection with one another he only recognized later on it its full measure; and he then placed the symptoms proper to the two, which in the first provings had been separated, one making the beginning and the other the end, in the “Chronic Diseases” immediately one after the other, an improved arrangement, which we also find in the best works on Materia Medica Pura of later times.
Many other things belonging to this rubric, but concerning the bodily individuality and presenting, as it were, the chief features in the portrait of the patient, are contained in those books under the heading of “general.” It would be desirable and would greatly facilitate the use if everything not pertaining thereto should be excluded, and the former be brought under a particular rubric denominated either “Individual” or “Personal,” in such a way that the corporeal would present a separate picture, as has been done with respect to the spiritual and mental.

2. Quid?
Of course this question refers to the disease, i.e., to its nature and peculiarity.
It may be unquestionably received as an axiom that we must first know an evil accurately before we are able to give any effectual aid against it. That occasionally relief may be given, without having first recognized the nature of the evil, as little refutes this axiom as the fact that an unexpected event occurs frequently which lies outside of our computation, and which either leads to good or evil, while neither the good will, nor the knowledge of the physician have the least to do with it.
But this axiom must be associated with another, which is no less true and no less important, namely this: That we must also know and possess the means which are able to relieve the evil when it is recognized. Where these are lacking, the former are of course of no avail.
Since the times of Hippocrates, thus since more than two thousand years, very much has been done with respect to the first point, and we have especially enjoyed a great progress and enlightenment within the last century and up to modern times. The path of pure observation and experience, which for a time had been pretty much forsaken, and on which that ancient Father of the healing art had gathered his valuable material, has again been entered upon. At the same time our contemporaries possess and use the great advantage enuring to them from the fact that they stand on the shoulders of their predecessors, and can thus view a greater circle of vision and, more especially, that astonishing progress has been made in all the subsidiary sciences, especially in chemistry and anatomy; so also they have had the advantage offered them by many physical instruments, which it must be confessed they have used with industry and care. By these means the modern physiological school, and, at the same time, the diagnostics of diseases, have reached an excellence not attained in earlier times.
The only thing of which every Homoeopath has to complain in this matter, is that things are conducted in too general a manner for his doctrine, and that almost universally diseases are described and treated of under the same name, which differ essentially in their nature, and require for their cure very different medicines.
An immediate result of this failing is, that Homoeopaths can make only a very limited use of the great advance made by the dominant school in diagnostics, since their generality excludes every special direction as to the suitable remedy.
Now since the modern Materia Medica of allopathy, as well as the older one, moves in the same generality, the conclusion follows almost inevitably that even the most cultivated allopath often stands undecided when he is to make a choice of remedies, so that almost every one of them will order something different, and that he is usually compelled to mix many thins together in order to cover the various indications.
More about this will be found in the course of this short treatise in a more suitable place, where the other questions are also discussed. Here I can only say so much about it.
a. That the most penetrating and most indubitable diagnostic as offered by the best allopathic manuals is rarely of ever sufficient for the Homoeopath, so as to enable him to make a sure selection of the remedy, and that
b. Such a diagnostic at most, and even then not always, may serve to exclude all those remedies from the competition which do not correspond with the common genius of the disease, but seem to act chiefly on other parts of the organism.

3. Ubi?
The seat of the disease really makes a part of the former question, but it nevertheless deserves to be more particularly emphasized, as it frequently furnishes a characteristic symptom, since almost every medicine acts more and also more decidedly on certain particular parts of the living organism.
These differences not only enter into consideration in certain so-called local diseases, but also in those diseases which are called by more general names, as affecting the whole body, e.g., gout and rheumatism. For it is probably never or very rarely the case that all parts of the body are affected in the same degree; even if it should be merely the case that the right side is more affected than the left or the reverse. But the examination of the parts affected is most necessary and most required when the whole to which they belong is larger, and is described merely in that general way which allopaths seem to delight in. Such names as headache, eyeache, toothache, colic and the like can in no way contribute to a rational choice of a remedy, not even when also the kind of pain is indicated.
Of course, the exact individualization of the ubi is most necessary in local ailments. Every Homoeopath knows from experience how necessary it is, e.g., in treating toothache, to select a remedy which in accordance with its provings on healthy persons has shown its action on the especial tooth to be treated. Among the most striking and decisive phenomena in this respect we should especially number the sores on the upper side of the joints of fingers and toes, which under allopathic treatment frequently prove very obstinate, and not infrequently become malignant, and necessitate an amputation, and, as I had an opportunity of witnessing here in two cases, may even have a fatal result. Every Homoeopath knows the efficacy of Sepia in these ulcers of the joints, which have no otherwise distinguishable features when this remedy is taken internally; without any external medication it will have a sure effect. Medicines which correspond to similar ulcers on other parts of the body in such cases are utterly useless.
If the practice of auscultation and percussion, as well as the use of the stethoscope, the plessimeter, etc., had been as well known to Hahnemann and his pupils as to our young physicians, they would no doubt have made the most extended use of the same for gaining a more exact knowledge and delimitation of interior ailments. They would have found out in lung troubles, e.g., definite local signs pointing to the use of certain remedies, and would have indicated them more accurately, and would not have limited themselves to defining them as being on the left or on the right side or at the top or below. To bring up to date and to specify more closely might be one of the chief duties for those who make additional provings at the present time, and might serve to an important and essential enrichment and completion of our Materia Medica more than a whole mass of confirmations of older symptoms or the finding out of new ones, which mostly have a lack of individuality.
At the same time it will be conceded from the allopathic side that the closer delimitation of the part affected, even though it may be of moment in the completion of the diagnosis, will be of no use to allopathic therapy, because this school is unacquainted with the peculiarities of the various medicines. No allopathic Materia Medica gives any information that the one remedy, e.g., corresponds more to the anterior or the posterior lobe of the liver, more to the upper or the lower part of the lungs, on the right or the left side, according to which the choice of the remedy may be made. Even if we Homoeopaths do not as yet know this as to all remedies, we do know it with respect to many of them, and for what is lacking we find a substitute in other signs, since, as is well known, all of these correspond to the remedy to be selected, at least they must not be opposed to it. Thence it may be seen that these new inventions, the value of which I am not in any way inclined to undervalue, have far less value in a therapeutic direction than in prognosis, where they show the extent and the dangerous nature of the malady.
Finally, we must yet consider in this question that neither the internal changes, which can be determined by these instruments, nor the material external changes, which manifest themselves openly to our notice, never present the dynamic disease itself, but are only its products, and are only developed in the course of the disease. When, therefore, these first beginnings are checked by the suitable remedy before those disorganizations take place, then these latter would not come to be developed, and it would be an inexcusable procedure to allow these sufferings to advance to a point where these material changes can be recognized in an artificial manner. It was necessary to mention this, in passing, in order that it may be shown how Homoeopathy proceeds, and to deny most decidedly the objection sometimes made that Homoeopathy is merely an expectative method, which allows the disease to develop without hindrance until it is too late to help. On the contrary, Homoeopathy knows and uses in infections diseases sure prophylactic remedies, which are always and exclusively such as have the power to heal the disease itself, and they never omit their use for the protection of those around the patient.

4. Quibus Auxiliis?
If the hexameter which we are following had been originally written for our doctrine, probably a more suitable expression would have been used in this instance, e.g., quibus sociis or quibus comitibus? Still the name does not matter, and it is manifest that it must refer to the accompanying symptoms.
Now since in Homoeopathy the chief aim consists in ascertaining the remedy which most completely corresponds to the totality of the symptoms, it is evident that this point is of the greatest importance and deserves the most careful consideration.
For every disease presents in its recognizable phenomena a more or less numerous group of symptoms, and it is only their totality which presents its complete image. This image may be compared to a portrait, which can only then claim to be a striking likeness when all the features of the original are faithfully presented in it. It is not sufficient that mouth, nose, eyes, ears, etc., should be presented in such a manner as characterizes man, and distinguishes him from the monkey and other animals but as every human physiognomy possesses its peculiarities and is distinguished from every other, so also here the more or less strongly pronounced abnormalities must most carefully and with the greatest faithfulness and truthfulness be presented and given their prominence. If therefore, retaining our former comparison, the nose should have a most peculiar form, color or size, it would not be sufficient to present this alone, though it should be most lifelike, and to add all the rest according to fancy, but also the secondary parts, which, as it were, form the background, must present a whole, such as it exists in reality, in order to give a perfect likeness.
It is from this point of view that the concomitant ailments are to be regarded when we select a remedy according to the motto: Similia similibus. Thence it is evident that the rare, striking and peculiar symptoms which present themselves demand a more prominent place than the common ones, because on them chiefly though not exclusively the similitude depends.
From this it naturally follows that the value of such concomitant symptoms for the purpose intended varies widely. But it would too far transcend the purpose of this contribution if I should adduce and explain all the many categories of value. I shall therefore limit myself to the presentation of a few of the most important points here involved:
First of all, those symptoms which are found in almost all diseases may be left out of our count, unless they manifest themselves in a striking manner.
The same obtains as to those ailments which are wont to appear as constant concomitants or at least as usual in the disease under consideration, unless they should be distinguished by some rare peculiarity and in this respect offer something characteristic.
On the other hand, all those attendant symptoms should be carefully noted which (a) rarely appear in connection with the leading disease, and are, therefore, also found rarely among the provings; (b) those which belong to another sphere of disease than the chief ailment, and (c) lastly, those which have more or less of the characteristic signs of one of the medicines, even in case they have not before been noticed in the present juxtaposition.
Now if besides this among the last mentioned concomitant symptoms there should be one or another in which the genius of one of the remedies should be plainly and definitely portrayed, so that it would be plainly pointed out, this one symptom thereby would acquire such an importance that it would even outweigh those of the chief ailment, and many then be at once considered as the most suitable. Such a symptom would be included among those which Hahnemann calls “striking, strange, unusual and peculiar (characteristic) signs,” and which are then “almost alone to be considered” because they preeminently give to the whole disease its individual character.
One circumstance deserves to be particularly mentioned here which particularly shows the importance and value of concomitant symptoms, namely, that several very efficient and in part specific remedies in certain diseases were discovered almost exclusively through them, the other symptoms indicating the main disease not having pointed in that direction, nor indeed could they have given such an indication, because the noticeable proximate signs could not sufficiently indicate the real peculiarity of the disease. This same system of concomitant symptoms also gives to Homoeopathy a much greater sureness in the treatment of diseases as compared with Allopathy, which first constructs for itself a frequently deceptive diagnosis of the disease, which at most only points out the genus of this disease, and where there are important attendant symptoms it endeavors to help itself by adding to the leading remedy given for the genus of the disease one or another remedy to cover the concomitant ailments.

5. Cur?
Why? The causes of the disease play a prominent part in pathological books, and justly. But a large part of this amounts only to guesses and attempts at explanation, which mostly have only a very subordinate value or none at all in the proper therapy of the disease, and which are too remote for our doctrine which is directed merely to the practical.
The causes of diseases are most generally and, indeed, very properly divided into external and internal. The internal causes properly refer only to the general natural disposition, which in some cases amounts to a peculiar supersensitiveness (idiosyncrasy). The external causes or occasional causes embrace everything which, where there is such an internal disposition to disease, may produce disease.
The general natural disposition which is also called the proximate cause, really belongs to the first question (Quis?) which respects the individuality of the patient. It only belongs here in so far as the consequences of a former disease may have modified the original natural disposition, and thus it deserves mention.
The occasional cause, however, is the matter with which the present question occupies itself and which deserves to be more closely considered. As to the natural disposition notified through previous diseases, this either depends on the miasmatic-chronic nature of those diseases as yet unexterminated, among which in agreement with the teachings of Hahnemann many homoeopaths even at this day count psora, syphilis and sycosis, or it is derived from the remains and after-effects of acute diseases, which when they do not belong to the former, as is frequently the case, constitute the numerous class of medicinal diseases or poisonings. Not infrequently, however, we meet with cases where both these momenta have cooperated to undermine the natural health, thus producing a monster of a disease which is even more deeply in-rooted and more difficult to combat.
As to the recognition and treatment of the first mentioned miasmatic diseases and their complications, Hahnemann himself in his masterly work on the Chronic Diseases left us the most complete directions, founded on many years’ experience. The much disputed division of medicines into antipsorics and non-antipsorics need not be considered here. It is enough to know that the former far excel the latter in their effectiveness in chronic diseases, and that their originator has nowhere excluded them from use in acute diseases. Later experience has also taught us that additional medicines from our medical treasury should be numbered in this category which have not been thus treated of in that excellent work. I am only sorry that Hahnemann has not been able to fulfill the promise which he gave me in writing, that he would treat as thoroughly and completely the images of syphilis and sycosis with his accustomed mastership as he had done in the above mentioned work (Vol. 1, p. 58 f. of the Second Ed.) with respect to latent and re-awakened psora.
Whether we may believe in what many somewhat derisively call Hahnemann1/4s Psora-theory, or reject the same, the attentive practitioner must frequently have found cases where even the remedy chosen with perfect correctness, in some acute disease, did not unfold its proper and decided effect before one of the so much criticized antipsorics – frequently Sulphur – had first been used, when psora had been involved, or an antisyphilitic or antisycotic when syphilis or sycosis had been present before and had remained uncured. It must, however, be confessed to be one of the most difficult tasks of the physician to always make the most suitable choice among the antipsoric remedies, as most of them have almost the same symptoms and very few truly characteristic symptoms are found with the different remedies. The more necessary is it for the homoeopath to study with continuous industry these lists of symptoms and to compare them with each other in order that he may pick up the scattered grains of gold for his use.
Poisonings and medicinal diseases are in one line and it makes no difference by whose hand any one has been deprived of his health by means of a substance injurious to his organism; among these substances medicines as well as poisons find their place. Of course, it is always of the greatest importance to know in every case the medicines or poisons, in order that they may be met by the proper well-known antidotes. The simple poisons may be pretty easily and surely recognized by their effects! It would have required but one case of poisoning occurring before the eyes of a Homoeopath for him bo have recognized the effects of Arsenic, which yet remained unknown to all the allopathic physicians, in the case of the thirty murders of Gessina Timme in Bremen, until the facts were obtained. In the medicinal diseases this is much more difficult, because seldom or never is one medicine given by itself, but always mixed with others; it can not, therefore, yield a clear and definite image. With these, therefore, it is necessary, as in the other case it is desirable, and it facilitates the treatment, if we can have a reliable account of what has preceded, and to be able to look over the prescriptions. Since this may be of use even later on, as the treatment proceeds, the journals of many Homoeopaths have a special rubric reserved for this subject.
We must consider these symptoms, called anamnestic, as being of special importance in this question. Although the ordinary consequences of such morbiferous circumstances and events are mostly already contained in the lists of symptoms of the medicines proved on healthy people, yet homoeopathic practice has long ago shortened and made sure the tedious and troublesome path of such investigations, and indicated for most of these cases the remedies which are foremost in their usefulness in such cases. This is e.g., very much simplified in cases of contusions, sprains, burns and the like. In other cases, e.g., in colds, the matter is already somewhat more complicated, since the kind of a cold and the part of the body affected offer differences which again point to different remedies. Thus there is a great difference in this respect as to whether the person has been simply exposed to the cold, or whether this took place while the body was in a perspiration, or if he at the same time got wet through. So also it is well known that different remedies are indicated when internal parts (stomach, abdomen, chest) have been exposed, or merely external parts (head, feet, back), and this must be carefully weighed in every case.
All this, as before said, is found among the symptoms in the Materia Medica; but when once it is known that a cold in the head from exposure to cold air, after previously being in a heated room, or after having the hair cut, points to Belladonna or Sepia; after taking cold in the feet, to Baryta or Silicea, and when at the same time there has been a wetting, to certain other remedies, then the attention will first of all be directed to these, and only comparison be made with others which are also occasionally indicated when the first are not sufficiently suitable.
Finally we must yet add a word under this question about infectious diseases, about which in pathological manuals we read so much that is contradictory and unreliable; the influence of which teachings is, however, much more far reaching than is generally supposed. To meet these diseases, which often spread until they become a real calamity, Homoeopathy has the most sure and approved prophylactics, and these, indeed, are the very same which have the power of healing those diseases when they have developed. Therefore, when we find in a family a case of infectious typhoid fever, there the same remedy, which has been given the patient in accordance with his symptoms, will also be sure to protect those in the house from infection, as it destroys the natural disposition thereto, and it will even in the shortest time restore those with whom there may have already been apparent the beginning of the disease. This last fact is the more important, as these first beginnings are usually so poor in symptoms that no certain choice can be founded on them; but the known occasional cause fully makes up for what is lacking. Of course, such a cure is not so brilliant as when the patient has been at the verge of the grave, but the gain for him and the consciousness of the physician is his sufficient reward.

6. Quomodo?
From his etymology, this preposition excellently describes the essence and the scope of the question before us. For the word Modus in the old classics not only refers to the manner and mode in general, but also to all the modifications which can take place in anything, thus the measure, the rule, the aim, the relations, changes, etc.; thus whatever, with the exception of time, which is included in our last question (Quando), possesses the ability to produce a modification, aggravation or improvement with the patient, naturally belongs, according to the usage of the language, to this rubric. This question has a double importance to Homoeopathy, first, because it was first discovered and developed by Homoeopaths, and is, therefore, their indisputable and exclusive property, and secondly, because all the results of provings and experience, without exception, belong to the more or less characteristic signs, of which no one is a matter of indifference, not even those of a negative kind.
Allopathy has never given any general attention, which might have been of use to therapy, to this momenta. At least its manuals on Pathology, Therapy and Materia Medica contain nothing of importance on this subject. Homoeopathy, on the other hand, soon after its discovery, recognized its great therapeutic value, and we find the first but already clear traces of it in Hahnemann1/4s “Fragmenta de viribus medicamentorum positivis,” which appeared in the year 1805. But during the progressive development of our science its importance appeared more manifest, and it was soon declared to be indispensable, so that in the later provings the attention was more and more directed upon it. On this account the latter provings are the more complete, with the exception of those made by Hahnemann in the Materia Medica Pura, which were elaborated with especial industry and on account of their constant use accompanied with copious notes.
If we compare the lists of symptoms of the medicines which have been proved somewhat fully, even a superficial survey will show that we find in almost every one of them the general indications of almost every disease; headache, colic, pain in the chest, diarrhoea, constipation, as well as dyspnoea, pains in the limbs, fever and cutaneous ailments, etc., are in no case quite absent. But if we study these indications somewhat more closely, with respect to the special parts of the body and the different sensations, then, indeed, differences will appear, and we frequently discover symptoms which appear more or less frequently in one remedy and are totally lacking in another. But the number continues too large to bring the decision to a sure and indubitable point, and we soon feel the need of securing additional points in order that we may find the true and suitable simile among the competing medicines. But the Quomodo with the Quando generally solves the riddle in the most satisfactory manner, and not only removes every doubt, but also furnishes the proof for the solution which we may have before supposed to be the right one. That in such investigations and comparisons we must also, as in what precedes, occupy the especial standpoint, is a matter of course. It is not sufficient, e.g., to merely consider motion in general in contrast with rest in the body, or in the part affected, we must also consider incipient and continuous motion, as well as the different kinds and degrees of motion. The same applies to lying down, we must not only consider the kind of position (on the back, on the side, doubled up, horizontal, etc.), but also aggravation or improvement in the parts affected by lying on the painful part, or the part not painful; all this is to be found out accurately and adapted to the remedy.
Quite a prominent part in this rubric is occupied by the partaking of food and drink, and this not only in diseases of the digestive organs, but also in fevers and other internal and external affections. Here it is not so much the amount of appetite, or thirst, to which also allopathy in some cases gives a proper importance, but especially the dislike or the desire for particular kinds of food and drink, and more especially also the change of condition after partaking of one or another article of food that often gives the most important hints as to the medicine to be selected. All experienced Homoeopaths have therefore always given the greatest attention to this subject, and it is very much to be desired that whatever different persons have discovered in this direction should be collected and published.
It was mentioned above, in passing, that even negative signs, so far as they belong to this rubric, should not be neglected. An example will show best what is meant by this: when a patient, for whose condition Pulsatilla seems suitable according to the five preceding questions, feels best while at rest in a warm room, while he feels uncomfortable in the open cool air, and also is fond of fat foods and bears them well, or offers other peculiarities which are in conflict with the characteristics of Pulsatilla, this would give an urgent cause to doubt the applicability of it to his case and to look for another remedy which also in these points corresponds with the symptoms.
I am sorry that the space for these contributions, which anyways may seem to have been already greatly exceeded, does not permit me to enter more in detail on one and another matter belonging to this division, as I may openly confess that I consider the indications obtained from this and the following question as the most important, indubitable, and therefore the decisive ones for therapeutical purposes. Even the numerous class of reflex actions, almost all of which fall into these two rubrics, do not by their internal contradictions diminish this importance, as soon as we know their mutual value, and are, therefore, enabled to estimate properly the worth of each.

7. Quando?
This last question concerns the time of the appearance, of the aggravation or the improvement of the ailments, and follows in natural order after the preceding, and is hardly of less importance in therapy than the last one.
From the time of Hippocrates and his commentators up to our times great attention has been bestowed on the periods of time in the various phases and stadia of the disease. The endeavor has been made to fix the period and continuance of the beginning, of the increase, the acme, the decrease and of the end of the disease. This would, indeed, make a useful contribution to the recognition and the characterization of the disease. But only in case it should be left altogether to itself and not be modified by medical interference. But on the other hand it can not be denied that this cannot give the least aid in the selection of the remedy, if only owing to the fact that the medicines cause disturbances in the natural course of the disease, which frequently lie altogether outside of all computation. Least of all can they be of any advantage to allopathic therapy, because it lacks all criteria from which to indicate the one or the other. I hope that I may not here hear the objection that, e.g., the periodical return of a fever points to an actual or a disguised intermittent fever and therefore indicates Quinine in its various preparations; for we are not likely to find a homoeopath who has not in his practice had to treat numerous victims of this error.
Homoeopathy intends something quite different in this question, having nothing in common with what precedes. But it is concerned with two momenta which have an immediate effect on the choice of the remedies, namely (a), the periodical return of morbid symptoms after a longer or shorter cessation, and (b), the aggravations and alleviations depending on the time of the day. These two will require but a few words.
The periodical return of morbid phenomena often coincides with periods of time which carry with them particular occasional causes. Among these are to be numbered the menstrual ailments, as well as those which are conditioned by the seasons, the weather, etc. Where such definite secondary causes cannot be discovered, and where as is mostly the case, the attacks are not closely bound to any sharply defined periods, they have no therapeutic value for homoeopaths as they lack the quality of a useful indication.
But of the greater importance are the aggravations and alleviations at particular times of the day, and this with respect to those which refer to single symptoms as well as those that refer to the general health. In this respect Homoeopathy possesses a great and valuable treasury of well proven experiences which are being more and more enlarged by careful observations. For there is hardly any disease, from the malignant internal fevers down to local ailments, in which during the different times of the day there does not manifest itself a more or less decided and distinct aggravation or alleviation. Now since homoeopaths have learned these peculiarities also in the various medicines during their provings on healthy persons, they are enabled to make extensive and blessed use of this peculiarity in their therapeutics, and they are obliged to do this in order that they may satisfy the rule Similia similibus also in this respect.
To demonstrate the preceding with some special facts, I will only adduce here the importance which the time of the day has on coughs with respect to the expectoration, as well with respect to the greater ease with which it is discharged, as also the consistence and the taste. Something similar we know about the stools, and although most of the remedies have diarrhoea among their indications, we so far know only of two (Conium and Kali carb.) where this takes place only by day and not by night.
With respect to the ailments which have a typical return, independent of other causes, we have a considerable series of remedies corresponding to this, without on that account excluding others, when they are indubitably indicated by their symptoms. Only in cases where this return is sharply and definitely pronounced, as for example in the evening from 4 to 8 o’clock (Helleborus and Lycopodium), or exactly at the same hour (Antimon. crud., Ignatia and Sabadilla), we should give it a special importance and only be careful that there may be no contraindications.

I conclude these contributions, which I have only hastily sketched down, with the hope that I may have succeeded in putting into the true light the difference between Allopathy and Homoeopathy and to incite my colleagues on their part to treat these important themes more at length, even if this be done only with respect to some one of the questions indicated at a time.

Clemens Maria Franz, baron von Boenninghausen 1858Share this ...
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On the Study of Homeopathic Materia Medica, Constantine Hering

 

heringThe ordinary mode for acquiring knowledge of remedial agents – namely, merely by experience during practice – cannot be termed studying the medicines, and no directions are required for it.
Much time and labor may be expended in this mode without ever attaining a complete command of the medicinal agents. Many a homeopathic practitioner will find himself in the situation of walking on a treadmill – setting machinery in motion, without moving from the spot.  He who trusts solely the experience and observations of others, and thinks that by means of published collections of cases he will also attain accuracy in the selection of medicines in individual cases, or find a similar accuracy in his general views of medicinal agents – such a one constantly remains in a state of dependence, moving merely in the narrow circle which others have chalked out.
In another country amidst other customs, and at other times when a different character of disease is present – indeed, during the prevalence of individual epidemic diseases – he stands helpless and bewildered. His pockets are full of paper money that is not current there, and his hands are destitute of any available coin.
He who relies only on his own experience for knowledge of medicines can only attain a very limited understanding. His personal knowledge will be quite imperfect as regards individual remedial agents. If, perchance, one or other property appears peculiarly prominent, then the others will be but seldom or never attended to.
For example, consider the case of Aconite, which certainly is of frequent use in inflammations, but much more often in cases where no inflammation exists. Or consider Belladonna, which is frequently employed where it does not answer at all, and where Hyoscamus., Arsenicum., Bryonia., or some other remedy, should be used instead.
So understanding acquired only in this way will be imperfect, in fine, as regards our whole material-medica – because by this method the knowledge of materia medica cannot but always be very deficient. Only a small number of favorite remedies will be retained in memory – merely such ones as are known, or thought to be known, to possess some general determinate properties which render their selection easy.
In the greater number of cases that come under daily observation, these favorite remedies will very frequently be given where they are not of the slightest use. A number of remedies will be employed for merely single symptoms. And a large number will never be  prescribed at all.
In cases of a more serious and rarer description, even where the most careful research is employed, it is often all in vain. For sometimes many remedies seem to be equally indicated, so it is difficult to make a selection from among them. At other times no single remedy seems applicable. The more intimate our acquaintance with the medicines, the more seldom will such cases occur, and the nearer is the physician to the attainment of complete mastery of his subject. Tyros, who have merely glanced at the remedies, imagine that it is not possible to become acquainted with a single remedy which has such a vast number of symptoms – just as a country clown on coming to town is at a loss to conceive how the people know which way to go among such a number of houses. And yet, in the course of time, he himself finds no difficulty in doing this. Let us observe how this happens. It may help us a little in studying the materia medica. It is well known that a perso n who has been in many large towns can much sooner find his way than other strangers who have not. This is true without there being much resemblance between the towns. He must unconsciously have invented some method by which he becomes quickly at home in every new town.
In like manner, many homeopaths have unconsciously adopted a method of studying the material medica. Our present object is to make this method known.
Learning the materia medica “by heart,” would be a highly absurd plan – and not only impossible on account of the extent of the undertaking, but even if possible, still, utterly useless. In order to acquire a foreign language, what good would it do to learn the dictionary from beginning to end? One who could repeat the list of symptoms of a remedy in their regular order would not thereby possess knowledge of the combination of symptoms – and it is that knowledge of which we stand in need. In practice, we never make use of the whole range of symptoms, but only of a particular combination of a small portion of them. To the general symptoms of every form of disease, corresponding ones may be found in a large number of remedies – and every remedy contains the indications of a vast variety of diseases.
The Goal Of Study
Every medicine has its peculiar characteristic traits which must occur in each of the groups that are mentioned above. There cannot be the least doubt about this fact. But this only shows the goal from afar – a goal that we may reach by a careful study of the materia medica. Up to this time, only a few fragments of such characteristic traits have been discovered. Anyone may soon learn these by heart; but this can never be called studying the medicines. Properly speaking, the study of the medicines is rather the road to a fresh discovery of those traits which, during practice, are continually presenting themselves to us. And, at the same time, it will show the fallacy of many well-known dicta proceeding from some who have attained the reputation of great authorities through the indolence of others.
The homeopathic physician who knows little more than the characteristics of a few polychrest medicines (with the addition, perhaps, of a few other scraps of knowledge which he himself picked up) has only a one-legged stool – we may turn ourselves hither and thither, but it will fall to the ground if not sat on by someone with two legs. The homeopathic physician who knows no more than this is like a bad chess player – someone who only knows one or two methods of giving checkmate which he has learned from studying the fag ends of games played by celebrated players – put together with but a few other modes he has discovered himself. The master of the game commands all the pieces in every situation. He shows his skill even when checkmated, and, properly speaking, he never loses. Even though the physician at the bedside of the patient has ever so carefully compared a medicine with the case before him, this will tend but little to advance his knowledge of it. And such a comparison cannot be termed a study of the medicine, as it is only viewed in connection with the case thus before him.
To study a remedial agent is to attentively observe its symptoms and curative powers, without any reference to particular cases or particular diseases. It is to consider all its effects as connected with one another. All its individual symptoms are seen as separate parts of a whole. The many changes produced in the sensations by its action, which have been separately observed and collected together, are to be regarded as symptoms of one and the same artificial disease. They are seen to belong to one morbid picture. The proper mode of studying the whole materia medica consists of first making one’s self the complete master of a few medicines. Afterwards comes the mastery of those medicines most nearly connected with the first few, and so on. There is always a comparing of the new ones with those that were first studied. On this account, I call this the diagnostic method. After one or more families of nearly related substances have thus been worked out, the others follow much more easily. After pursuing the study in this manner with unremitting diligence for several years, then any new medicine may be made available after only one perusal. By carefully reading it over only once, so much remains impressed on the memory by the unconsciously acquired habit of comparison, that in a case of disease in which it is indicated, it is easily recalled to mind. He who can do this will not complain of the number of imperfectly proved medicines, or of the fewness of their recorded symptoms, while at the same time finding fault with the large number of symptoms presented by other medicines. Be the symptoms as numerous as they may, he can make himself be the master of them. Be they ever so small in number, he understands how to avail himself of them. He who has not the requisite foundation finds all additions to the materia medica a disagreeable burden. He shows by his discontent that he has not yet made himself master of the old matter. Methinks most of those who complain of our materia medica, are either totally ignorant of, or have but a scanty acquaintance with, our medicines.
Before we proceed to give specific directions, we shall:
1. Endeavor to defend the method we have proposed
2. Show how a single medicine is to be studied
3. Show how the others are to be connected to this one
A Defense Of The Method We Have Proposed
The assertion that one remedy must first be perfectly known, and that then the rest will be acquired with less difficulty, and still more easily the farther we advance, is founded on the principles and practice of mnemonics. This diagnostic method, indeed, appears to me to be the only practical plan of studying the material medica, or at any rate, the shortest and most direct way of attaining the end proposed. There are certainly two other possible methods. One is to learn what are called the principal symptoms of each medicine. The other is to study each substance by itself, and thus, all of them unconnectedly. A fourth and last method would be, not to study the materia medica at all. (Exempla sunt odiosa!)
To learn the so-called principal symptoms – e.g., to extract from an epitome like Jahr’s Manual, the most prominently marked sentences, and to get these off by he art – is the shortest way to practice. But, at the same time, it is the surest way to permanent mediocrity. Let him who is forced to make a trade of his profession, adopt this method. It will bring him soonest into the center of the woods. But let him not forget to secure at the same time a permanent possession. If not, he will resemble the squatters in the far west, who establish themselves without troubling their heads about their right to the soil. And when the buyer of the land chases them off, they remove to a distance, out of one wretched wooden hut into another. They barely support their existence by the scanty profits arising from ill cultivated ground, and the uncertainties of the chase. This superficial, unmeaning sort of life has charms for them. And their labors, together with those of the destructive wood louse, lighten the task of the settler. Those qualities that we at present term the principal symptoms of the medicines are, for the most part, unsatisfactory – nay, they prove an obstacle in the way of accurate individualization, and lead to carelessness. It is much more convenient to administer to patients a dozen homeopathic remedies according to this principle, than any plan of the old school. And one may, by such practice, be pretty sure, that by the end of the year a number of p atients will have recovered. These principal symptoms are, moreover, in many instances incomplete, and in many others perfectly false. They can only be known with certainty, and have their due value assigned them, by a careful study of the various medicines, having especial regard to their relations one with another. A mere acquaintance with these principal symptoms cannot be called studying the remedies. If we were in possession of a scientific arrangement of the materia medica, we might make it the basis of our study of the medicines. But at present, we cannot expect to construct anything satisfactory on such an uncertain and incomplete basis. He who seeks to study the medicines according to their symptoms, but each medicine separately and without instituting a comparison between them, will, with the very best memory, not advance far before forgetting what he had previously learned. The memory is incapable of retaining any thing but what is presented to it in connection with something else. An idea is easily brought to the recollection only when in connection with others.
We would remind him who has had no experience of the comparative method, either on himself or others, that acquiring a knowledge of the symptoms of medicines, is exactly similar to the mode in which the chemist, the mineralogist, the botanist, and the zoologist acquire a knowledge of the objects connected with their respective sciences. We should, therefore, set about it in a similar manner. Let it be considered what a multitude of signs are so perfectly at the command of the zoologist, that he can easily recall them to his recollection. Although no one is capable of giving a complete description of all animals, a repetition of all their characteristics “off the book,” as the saying is. Yet the zoologist can at once tell a new animal when he sees it. He can instantly determine to what class it belongs, and point out its particular characteristics. By merely looking at each animal, he already knows its characteristic peculiarities, or at least has no difficulty in discovering them. The homeopathic physician must do just the same with his medicines. Let it not be alleged that zoology and the other branches of natural science are things quite different from our science. It must be regarded and dealt with in exactly the same manner as the natural sciences.
Let it not be said that those sciences are so far advanced, and the system so perfect, that every thing connected with them is much easier. Suppose that our materia medica were at present as little advanced as a natural science – as zoology in the time of Aristotle. This should not deter us from regarding it as such, working it out as such, and studying it as such. By this means we should make as much progress in it as was then made in zoology – and that is a good deal in comparison to knowing nothing at all, or to wandering in benighted ignorance amidst a profusion of everything. I refer to those who possess a real knowledge of our materia medica, if that has not been obtained in the way I have just pointed out – and I doubt not that some now see that they have unconsciously obtained their knowledge in the same manner. There can only be one right way. But this may have been pursued without the individual being exactly aware of it himself, as has happened to those proficient in many of the arts. 
When one remedy has been accurately studied, and the art has been acquired of classing others along with it according to their resemblance and of distinguishing the differences between them, then each subsequent group that is studied in a similar manner costs far less trouble. The result will be that he who has thus made himself master of a hundred medicines will require for the second hundred scarcely so much time and labor as he expended on the first ten. An increase of the medicines, therefore, ad infinitum, will never prove too much for human capabilities. Entomologists can easily acquire knowledge of a number of new insects. It requires little trouble on the part of the botanist to learn an endless succession of new plants. This they do by a speedy conception of the resemblances and differences among them – and the more practice they have, the easier it is. It may be urged that no such laborious mode need be adopted to acquire of one of the natural sciences, but that the general characteristics of the various classes are soon learned. In the present state of the natural sciences, all the relationships existing among the various classes and orders may be seen at a glance, and the study of them thereby greatly simplified. But, as we have not brought our materia medica to such a pitch of perfection – and from the short time of its existence, it has been impossible to advance it farther than it is at present – we must dispense with this simplifying glance. We must, however, on this account, follow the only path that leads to this end – laborious though it be at present. As the progress of inventions facilitates commerce and travel more and more, so the progress of science always lightens the task of learning what has been discovered. The same will be the case as regards the materia medica. Until that time comes, we must study the remedies as we find them. The time is, we hope, not far distant, when we shall be able to talk about the objects of our science in the same manner as natural historians do of theirs – when, like them, we may be able to give complete descriptions of these objects without touching upon unimportant information.
The time, we hope, is at hand when we shall know what is and what is not important in our material medica.
How Is A Single Medicine To Be Studied?
How can a remedy be studied, if the symptoms are not learned by heart? It can be learned through the same principle as the whole materia medica – by comparison. The symptoms of a medicine are to be read through carefully several times. This should be done from beginning to end, in the first years of study, with the pen always in hand. While reading, one thing or other is always to be particularly attended to.
— The First Reading —
At first attention should be directed to the organs in which the symptoms occur. It will be at once noted that many organs or tissues are particularly attacked. The organs that show the greatest number of symptoms are to be regarded according to their physiological relationship. In this, our previous studies are a great assistance, just as every physiological dogma, every hypothesis, even though false, is an aid to the memory.
Thus, the ear is said to be the peculiar organ of the osseous system. Therefore, when pains or nodes in the bones occur, I would observe attentively the symptoms of the ear. And, in this manner, many individual symptoms would appear more significant where connections exist. For instance, between the functions of the skin and kidneys, symptoms occurring in the one system will always call to our mind those of the other – whether those symptoms harmonize with or are opposed to one another. In our comparison, pathology will also be of use, and that will be so whether its theories are true or false. Thus, where symptoms referable to the liver occur, I would always compare the pains in the right shoulder, and vice versa. Where turbid urine is passed in small quantity, I would pay attention to the symptoms which point to the serous cavities. In doing this, for example, when studying Aurum, a number of symptoms would thereby appear more important, and consequently be more deeply impressed on my mind. And this remedy would occur to my memory not only in cases of effusion into the pericardium, but also in hydrothorax and ascites.
The important observation of Neumann – that diabetes is always preceded by a diminution in the activity of the kidneys – will be often serviceable in our consideration of the medicines. It will, for example, help to confirm the supposition that not much is to be expected from Argentum in cases of diabetes, and that this disease is mentioned in our repertories in connection with silver in this manner: Hahnemann, distrusted the alleged diuretic properties of nitrate of silver. Rather he ascribed to it powers that are exactly the reverse. But as far as I know, he does not adduce a single instance of its efficacy. While studying the symptoms of Phosphoric acid, we should call to mind the same observation that is also the recorded experience of its efficacy in several cases of milky urine – a kind of diabetes. In this manner we will see that a large number of the symptoms may be pathologically connected. During the first reading and comparison, the symptoms arrange themselves, as it were, into some sort of definite form. Thus we gain a collective impression of the whole that we retain in the memory, and recall to mind in all cases where the remedy is suitable.
— The Second Reading —
During a second perusal of the medicine, attention should be directed at the character of the symptoms. The former perusal was but a preparation for this step. The character of the pains in different parts should be compared – all pains or other sensations of the same, or a similar or a nearly related kind, that occur in different parts should be carefully observed. If this is done, it will be found, for example, that burning pains occurring frequently in various parts are not peculiar to Arsenic and Carbo-vegetabilis alone, but they also occur in Phosphoric acid and other substances. The mind will take a comprehensive view of them, and a complete picture of them will be retained.
At the same time, attention must be paid to the parts where these pains principally occur. Thus, we note whether the burning pains are more in the mucous membranes, or in the serous cavities, or in other parts. For instance, the burning pain in the case of Arsenic occurs most frequently internally, in the blood vessels. In the case of Carbo veg. pain is seen more externally, in the skin and joints. Both substances cause burning in the stomach and bowels, but Arsenic to a greater degree.
On the other hand, Carb. veg. causes much more in the breast – and so forth. In every substance where the same description of pain prevails, an attentive examination will show the characteristic features of each. We will soon discover that certain kinds of pain prevail in certain organs and tissues, e.g., tearing in the muscles, dartings in the chest, cuttings in the abdomen, pressure in the head, compression in the ears, boring in the bones, etc. But this we shall enter into more particularly in another place. This tends much to assist the memory, both directly and indirectly – the circumstance of an unusual pain occurring in any organ would be the more observed. A number of isolated symptoms are, moreover, more easily remembered in connection – when placed side by side.
For example, with respect to Aurum, it produces determination of blood to the head, to the chest, to the eyes; toothache from a similar cause; determination of blood to the legs; and many other symptoms that may be found to be connected with these.
An accordance of many of the symptoms of different organs may often be observed. Thus Caust. has sparks, flickerings, figures, an appearance of gauze before the eyes. Also, it has ringing,whistling; singing, chirping in the ears. On the other hand, Phosph. has points and spots, dark, black, and gray veils before the eyes; loud noises, buzzing, throbbing in the ears. After the moral symptoms have been arranged in groups, they may be easily impressed on the memory by comparing them with the corresponding symptoms of other organs. Thus anxiety, melancholy, etc., are to be compared with the symptoms of the heart and chest – or a weak, wandering, or obstinate state of mind, is compared with the frequently analogous symptoms of the digestive organs. And so forth.
— The Third Reading —
At the third reading, the conditions under which the symptoms take place should be noted. This must always be done pen in hand, even though Ruckert’s comparative work be employed. Doing it one’s self has great advantages, especially at the commencement of the study. One is exercised thereby; and all that has been previously learned is at the same time revised. It should be observed whether the symptoms take place on the right side or the left. If this has not been done previously, note at what part of the day they occur, when our pathological knowledge will be of great assistance to us. Observe in what attitudes, positions, during what motions, etc., the symptoms occur. Care should be taken not to indulge in vague generalities, such as “aggravation in the evening,” “worse on motion,” and the like. This is of small use in acquiring knowledge of the medicine, and it is an obstacle in the choice of it as a remedy. What we wish to know is, what symptom is aggravated in the evening or on motion. When possible, this symptom should be noted along with some connecting idea. Since Hahnemann taught us to distinguish between Bryon. and Rhus. by pointing out their opposite qualities – motion producing aggravation in the one case and rest in the other – it has frequently happened that too much value has been assigned to this circumstance in the choice of Bryon. Many other similar remedies are distinguished by possessing a similar pair of opposite properties – Bell. and Hyosc.; Nux. and Puls.; Chin. and Seneg.; Phos. and Nitr.; Sulph. and Con.; Carb. And Dros.. These along with many other substances bear the same relation to each other as Bryon. and Rhus.
Bell. has a far larger number of symptoms that are worse on motion than Bryon. – yet the symptoms that are worse on motion are perfectly distinct. As regards Bell., they occur mostly in the vascular system. With Bryon. they are chiefly to be found in the joints. The symptoms of the respiratory organs with Bryon. are not aggravated by motion. However, those produced by Bell. are decidedly so. One should be careful of coming to a converse conclusion. I mean to say, in the case of a remedy having a number of symptoms that are aggravated by rest, it does not follow that they will be ameliorated by motion, and vice versa. Thus Dulc. has many symptoms that are better on motion, but very few that are worse when at rest.
— The Fourth Reading —
The remedy may be perused yet a fourth time, with particular attention being paid to the combinations of the symptoms. The student may carefully observe what symptoms follow each other or occur simultaneously. However, the attention must have been previously directed to this point. When this was not the case, the student should seek to bring these combinations into connection with his former observations. Care should be taken not to adopt the notion that a remedy can cure groups of symptoms in a patient only if they occur in the order it produces them. A remedy is capable of curing groups of symptoms which it does not produce in the same combination at all – groups whose component parts were observed in a number of different provers, and frequently in quite a different order. From a pathological point of view, a special study of a medicine which compares it at the same time to different forms of disease may be useful after a thorough knowledge of the symptoms of the medicine has been acquired. Experience teaches us that a number of apparently perfectly different diseases, which are far asunder in pathological works, may still be cured with the same remedy. It would consequently be necessary to go over almost all diseases in connection with the remedy. This would be a great waste of time, and would not lead to a perfect knowledge of the remedy after all – our pathological systems are very far from being complete enough for this. It would be well, however, to compare the description of individual forms of disease, with many classes of remedies. Thus, for instance, those catarrhs which indicate Mercury and allied medicines are very dissimilar to those in which Arsenic, and medicines of its class, are efficacious.
How Other Medicines Are To Be Connected To This One
After a thorough acquaintance with one or more remedies has been gained in the above manner, the student must then pass on to others. The best course will be to go on next to those most nearly allied. The study of the second remedy is already somewhat easier. This is partly owing to the practice that has been had in acquiring knowledge of the symptoms, and partly because deviations from the character of the last studied medicine become more vividly impressed upon our mind. We must, consequently, have a very clear perception of these differences. They must assist us to attain a distinct idea of the peculiarities of the second medicine, as well as to stamp the knowledge of the first more forcibly on our memory. Therefore we must search for resemblances and observe differences in the more prominent symptoms – and in those that are more easily remembered, rarer, and more striking. I have called attention above, in the examples of Bryon. and Bell., Caust. and Phosph., Arsen. and Carb. veg., to the fact, that medicines which otherwise present great similarities in their symptoms, are yet widely different in certain respects. No regard needs to be paid to slight differences, nor even to whole groups of symptoms which one of the medicines has, and the other has not. No attention need be given to the fact that, in one case many symptoms are known, while with the other, very few are.
These factors may, however, demand our attention in cases where the different characters of the remedies are thereby marked – as in the case of Bell. compared with Bryon. regarding the moral symptoms, the effects upon the organs of the senses, the symptoms of the throat, etc. The differences sometimes lie in the combinations of symptoms, whereby they may present resemblances to perfectly different diseases.
More frequently, and much more clearly, these differences are expressed in the conditions under which the symptoms occur. These are often exactly opposite. Thus the very similar headaches produced by Bell. and Bry. occur in the former in the evening, in the latter in the morning. These differences are sometimes very subtle. For instance, most of the exacerbations of Acid. nitr. occur in the evening, but those of Acid. mur. are before midnight. Those of Acid. sulph. are after midnight, and those of Acid. phosph. are seen towards the morning. But all the acids present nocturnal aggravations. Symptoms of an opposite character are rare. But differences in nature are very frequent, as is the case in the gastric symptoms of Bell. and Bry., Bry. and Ant. crud., Ant. crud. and Ipec., etc. Symptoms in opposite situations are more frequent. Thus, similar symptoms are often distinguished by occurring in one case on the right, in another on the left side – as happens with Arn. and Lach and others. The catarrhal affections of Bell. are distinguished from those of Dulc. in that those of the former occur more in the mucous membranes of the head and neck – in the region of the carotids – where those of the latter occur more in the chest and abdomen – in the course of the descending aorta, etc. Beginners are apt to attend too much to specialties when making these comparisons. This over attention becomes a very laborious task, and is apt to lead to a total abandonment of the study.
There is, however, no better way of avoiding this error, and of learning how to make one’s self quickly the master of the generalities, than to surmount undauntedly the laboriousness of the beginning.
On a second comparison, the mind is more accustomed to the work. According to the talents and previous acquirements of the student, will it be a longer or shorter time before he comes to be able to complete the comparison of two remedies in a few days. We must caution those who pay too much attention to specialties not to be so very minute, but above all things to seek for points of crystallization. We must point out to those who are disposed to be superficial that important discoveries for practice may be made by a careful comparison. The comparisons may be very easily made by means of Ruckert’s systematic tables. The remedies to be compared are to be sought out in each division, their symptoms carefully read, and the result committed to writing. A separate column is assigned to each medicine. Those symptoms which both have in common should be written in the middle. When there is only similarity, the sign of similarity should be placed in the middle between them. Where opposites, or well-defined differences exist, they should be distinguished by an interposed arrow, etc. It cannot be expected that anyone, least of all a beginner, will compare every remedy with every other. The student should select remedies for this purpose that he considers to be analogous, and which are known to possess important properties. All remedies that are closely related by the source of their derivation, must also be related with respect to their symptoms. All that are chemically allied must be so medicinally. Those possessing similar odors – as are Phosph., Ars., All. sat., Asaf., and Bufo. – must possess resemblances in their symptoms, etc. The chemical preparations may be arranged in natural families, according to one or other system. Those nearly related are thus compared, e.g., Sulph. and Phosph.; Chlor. and Iod.; the carbons and Graph.; the oxygenous acids, Nitr. ac., Sulph. ac., and Phosph. ac. are compared with each other, and with the hydrogenous acids, Mur. ac., Hydrocyan. ac. Further, Sil., Alum.; the carbonates of potash, soda, and ammonia; Bar. and Stront.; Calc. And Magn.; the muriates of soda and Am., Bar. and Magn. The acetates of Cupr., Ferr., Plumb., Mang.; the metals Aur., Plat., Stann., Arg., and Zinc. Interesting comparisons may be made between Phos. ac. and Phos.; Sulph. ac. and Sulph.; as also Sulph. and Hep., Hep. and Calc.
Medicines From The Vegetable Kingdom
Among medicines belonging to the vegetable kingdom, those which may be compared as being nearly allied, are:
Anac. and Rhus.
Bryon. and Coloc.
Ind. and Tong.
Op. and Chelid.
Spig. and Menyanth.
Viol. od. and Jac.
Thuya. and Sabin.
Coff., Ipec., Chin.
Colch., Verat., Sabad.
Euphr., Dig., Grat.
Lauroc., Prun. sp., Amyg. am.
Led., Rhod., Nux vom., Ign., Oleand.
Arn., Cham., Cin., Leont.
Asa., Cic., Con., Aet., Phell.
Bell., Caps., Hyosc., Stram., Tab., Verb.
Acon., Clem., Hell., Puls., Staph., Ran. bulb., and Sol.
The cryptogamous plants, Agar. musc., Bov., Lycop., are too remote from each other – and yet their symptoms are much more similar than those of the more nearly related families of Solaneae and Ranunculaceae. Sec. can only be judged from from the cures it has effected – the symptoms of it derived from epidemic diseases are not to be relied on.
It is worthy of observation that the differences of those substances which are allied in their origin lie principally in the conditions of the symptoms; whereas those substances nearly connected by the similarity of their symptoms alone, agree merely in single departments of symptoms, but in others have quite a different character and seat. Families of substances that are related only in their symptom may be formed from such medicines as may be employed with advantage in succession – or which serve as antidotes to each other. In the present state of homeopathic literature, the formation of such families is a very hazardous experiment. But they are of much greater practical value than those formed from their natural affinity.
It is perfectly evident that substances that have a similar origin must produce many similar symptoms. Our business should be to search for the differences, in order to avoid confusion. When, however, minerals, plants, and animals, widely different from each other, produce similar groups of symptoms, there must be some deeper reason for this. It must indicate the similarity of the medicinal to the natural diseases. Such allied medicines are in general the best antidotes of each other. However – as must happen from the rules laid down above – among the metals that form several families, there are antidotes which are never found among those that are nearly connected, but always among those that are widely separated. Thus it follows that Sel., Ars., and Am.; Plat. and Argent.; Stan. Plumb., Zinc. and Nic.; Ferr. And Mang. do not antidote each other. But the metals Plumb. and Plat.; Ferr. and Ars.; Am. and Merc. do.
Among plants there must be antidotes in each family, and perhaps in each genus. There are, indeed separate parts in every plant and animal, which seems to have a power of neutralizing the effects of the others. Other homeopathic writers have pointed out a close connection between the two naturally allied substances Nux. and Ign., on the one hand, and the symptomatically allied Puls. – to which may be added Cham., Coff., and Caps. We may, I think, also reckon Ambr. among these. Another family is Ars., Verat., Ipec., Asar., to which we may add Ferr. and Chin.; perhaps also Staph., and Ac. sulph. Sulph., Calc., and Lyc. are well known as doing well in succession – to which may be joined Led., and in another point of view, Therid.
One of the most remarkable and beautiful families is Hep., Merc., Bell., and Lach. Between these and those allied to Arsen., may be placed Phos. ac. and Carb. veg., and those related to them, as also Cupr., and on another account Aur. Anyone who has thoroughly made himself master of two or three families, and then from time to time makes a comparison between two remedies which appear to him to be related – and between which he has frequently needed to make a most accurate choice in practice, as for instance, Sulph. and Ferr.; Phos. and Caust.; Ars. and Carb. v.; Bell. and Bry.; Bry. and Rhus.; Rhus. And Dulc., etc. – this homeopathic doctor gradually obtains such an extensive basis of knowledge that all the rest of the remedies are acquired without difficulty. If a crystal of salt is suspended in a saturated solution of the same salt, the most beautiful crystals collect upon it.
So, one who is acquainted with a large number of medicines in the above manner, can thereafter compare every medicine with every other in a very short time – and without many quires of paper. This must happen before our materia medica, which ought to belong to the natural sciences, can be looked upon as one of them.

from “Wirkungen des Schlagengiftes”
Allentown und Leipzig, bei C. Kummer, 1837
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British Journal Of Homeopathy
vol. II 1844 no. 7Share this ...
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