Aphorism 201
It is evident that man's vital force, when encumbered with a chronic disease which it is unable to overcome by its own powers instinctively, adopts the plan of developing a local malady on some external part, solely for this object, that by making and keeping in a diseased state this part which is not indispensable to human life, it may thereby silence the internal disease, which otherwise threatens to destroy the vital organs (and to deprive the patient of life), and that it may thereby, so to speak, transfer the internal disease to the vicarious local affection and, as it were, draw it thither. The presence of the local affection thus silences, for a time, the internal disease, though without being able either to cure it or to diminish it materially. The local affection, however, is never anything else than a part of the general disease, but a part of it increased all in one direction by the organic vital force, and transferred to a less dangerous (external) part of the body, in order to allay the internal ailment. But (as has been said) by this local symptom that silences the internal disease, so far from anything being gained by the vital force towards diminishing or curing the whole malady, the internal disease, on the contrary, continues, in spite of it, gradually to increase and Nature is constrained to enlarge and aggravate the local symptom always more and more, in order that it may still suffice as a substitute for the increased internal disease and may still keep it under. Old ulcers on the legs get worse as long as the internal psora is uncured, the chancer enlarges as long as the internal syphilis remains uncured, the fig warts increase and grow while the sycosis is not cured whereby the latter is rendered more and more difficult to cure, just as the general internal disease continues to increase as time goes on.
Aphorism 202
In the old-school physician should now destroy the local symptom by the topical application of external remedies, under the belief that he thereby cures the whole disease, Nature makes up for its loss by rousing the internal malady and the other symptoms that previously existed in a latent state side by side with the local affection; that is to say, she increases the internal disease. When this occurs it is usual to say, though incorrectly, that the local affection has been driven back into the system or upon the nerves by the external remedies.
Aphorism 203
Every external treatment of such local symptoms, the object of which is to remove them form the surface of the body, whilst the internal miasmatic disease is left uncured, as, for instance, driving off the skin the psoric eruption by all sorts of ointments, burning away the chancre by caustics and destroying the condylomata on their seat by the knife, the ligature or the actual cautery; this pernicious external mode of treatment, hitherto so universally practiced, has been the most prolific source of all the innumerable named or unnamed chronic maladies under which mankind groans; it is one of the most criminal procedures the medical world can be guilty of, and yet it has hitherto been the one generally adopted, and taught from the professional chairs as the only one.
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Aphorism 204
If we deduct all chronic affections, ailments and diseases that depend on a persistent unhealthy mode of living (Aphorism 77), as also those innumerable medicinal maladies (v. Aphorism 74) caused by the irrational, persistent, harassing and pernicious treatment of diseases often only of trivial character by physicians of the old school, most the remainder of chronic diseases result from the development of these three chronic miasms, internal syphilis, internal sycosis, but chiefly and in infinitely greater proportion, internal psora. Each of these infections was already in possession of the whole organism, and had penetrated it in all directions before the appearance of the primary, vicarious local symptom of each of them (in the case of psora the scabious eruption, in syphilis the chancre or the bubo, and sycosis the condylomata) that prevented their outburst; and these chronic miasmatic diseases, if deprived of their local symptom, are inevitably destined by mighty Nature sooner or later to become developed and to burst forth, and thereby propagate all the nameless misery, the incredible number of chronic diseases which have plagued mankind for hundreds and thousands of years, none of which would so frequently have come into existence had physicians striven in a rational manner to cure radically and to extinguish in the organism these three miasms without employing local remedies for their corresponding external symptoms, relying solely on the proper internal homoeopathic remedies for each.
Aphorism 205
The homoeopathic physician never treats one of these primary symptoms of chronic miasms, nor yet one of their secondary affections that result from their further development, by local remedies (neither by those external agents that act dynamically, nor yet by those that act mechanically), but he cures, in cases where the one or the other appears, only the great miasm on which they depend, whereupon its primary, as also its secondary symptoms disappear spontaneously; but as this was not the mode pursued by the old-school practitioners who preceded him in the treatment of the case, the homoeopathic physician generally, alas! finds that the primary symptoms have already been destroyed by them by means of external remedies, and that he has now to do more with the secondary one, i.e., the affections resulting from the breaking forth and development of these inherent miasms, but especially with the chronic diseases evolved from internal psora, the internal treatment of which, as far as a single physician can elucidate it by many years of reflection, observation and experience, I have endevored to point out in my work on Chronic Diseases, to which I must refer the reader.
Aphorism 206
Before commencing the treatment of a chronic disease, it is necessary to make the most careful investigation as to whether the patient has had a venereal infection (or an infection with condylomatous gonorrhoea); for then the treatment must be directed towards this alone, when only the signs of syphilis (or of the rarer condylomatous disease) are present, but this disease is very seldom met with alone nowadays. If such infection have previously occured, this must also be borne in mind in the treatment of those cases in which psora is present, because in them the latter is complicated with the former, as is always the case when the symptoms are not those of pure syphilis; for when the physician thinks he has a case of old venereal disease before him, he has always, or almost always, to treat a syphilitic affection accompanied mostly by (complicated with) psora for the internal itch dyscrasia (the psora) is far the most frequent fundamental cause of chronic diseases. At times, both miasms may be complicated also with sycosis in chronically diseased organism, or, as is much more frequently the case, psora is the sole fundamental cause of all other chronic maladies, whatever names they may bear, which are, moreover, so often bungled, increased and disfugured to a monstrous extent by allopathic unskilfulness.
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Aphorism 207
When the above information has been gained, it still remains for the homoeopathic physician to ascertain what kinds of allopathic treatment had up to that date been adopted for the chronic disease, what perturbing medicines had been chiefly and most frequently employed, also what mineral baths had been used and what effects these had produced, in order to understand in some measure the degeneration of the disease from its original state, and where, possible, to correct in part these pernicious artificial operations, or to enable him to avoid the employment of medicines that have already been improperly used.
Aphorism 208
The age of the patient, his mode of living and diet, his occupation, his domestic position, his social relations and so forth must next be taken into consideration, in order to ascertain whether these things have tended to increase his malady, or in how far they may favor or hinder the treatment. In like manner the state of his disposition and mind must be attended to, to learn whether that presents any obstacle to the treatment, or requires to be directed, encouraged or modified.
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Aphorism 209
After this is done, the physician should endeavor in repeated conversations with the patient to trace the picture of his disease as completely as possible, according to the directions given above, in order to be able to elucidate the most striking and peculiar (characteristic) symptoms, in accordance with which he selects the first antipsoric or order remedy having the greatest symptomatic resemblance, for the commencement of the treatment, and so forth.
Aphorism 210
Of psoric origin are almost all those disease that I have above termed one-sided, which appear to be more difficult to cure in consequence of this one-sidedness, all their other morbid symptoms disappearing, as it were, before the single, great, prominent symptom. Of this character are what are termed mental diseases. They do not, however, constitute a class of disease sharply separated from all others, since in all other so-called corporeal diseases the condition of the disposition and mind is always altered; and in all cases of disease we are called on to cure the state of the patient's disposition is to be particularly noted, along with the totality of the symptoms, if we would trace an accurate picture of the disease, in order to be able therefrom to treat it homoeopathically with success.
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