Nature of Chronic Diseases – 2
by Samuel Hahnemann
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The oldest monuments of history which we possess show the Psora even then in great development. Moses* 3400 years ago pointed out several varieties. At that time and later on among the Israelites the disease seems to have mostly kept the external parts of the body for its chief seat. This was also true of the malady as it prevailed in uncultivated Greece, later in Arabia and, lastly in Europe during the Middle Ages. The different names which were given by different nations to the more or less malignant varieties of leprosy, (the external symptom of Psora) which in many ways deformed the external parts of the body, do not concern us and do not affect the matter, since the nature of this miasmatic itching eruption always remained essentially the same.
(*In Leviticus not only in the thirteenth chapter, but also (chapt. 21, verse 20) where he speaks of the bodily defects which must not be found in a priest who is to offer sacrifice, malignant itch is designated by the word garab, which the Alexandrian translators (in the Septuagint) translated with psora agria, but the Vulgate with scabies jugis. The talmudic interpreter, Jonathan, explained it as dry itch spread over the body; while the expression, yalephed, is used by Moses for lichen, tetter, herpes (see M. Rosenmueller, Scholia in Levit., p. II., edit. sec., p. 124). The commentators in the so-called English Bible-work also agree with this definition, Calmet among others saying: Leprosy is similar to an inveterate itch with violent itching. The ancients also mention the peculiar, characteristic voluptuous itching which attended itch then as now, while after the scratching a painful burning follows; among others Plato, who calls itch glykypikron, while Cicero marks the dulcedo of scabies.)
The Occidental Psora, which during the Middle Ages had raged in Europe for several centuries under the form of malignant erysipelas (called St. Anthony’s Fire), reassumed the form of leprosy through the leprosy which was brought back by the returning crusaders in the thirteenth century. And though it thus spread in Europe even more than before, (for in the year 1226 there were in France alone 2,000 houses for the reception of lepers), this Psora, which now raged as a dreadful eruption, found at least an external alleviation in the means conducive to cleanliness, which also were brought by the crusaders from the Orient; namely, the (cotton? linen?) shirts before unknown in Europe, and the more frequent use of warm baths. Through both of those means, as well as through the more exquisite diet and refinement in the mode of living introduced by increased cultivation, the external horrors of the Psora within the space of several centuries were at last so far moderated, that, at the end of the fifteenth century it appeared only in the form of the common eruption of itch, just at the time when the other miasmatic chronic disease, syphilis, began (in 1493) to raise its dreadful head.
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Thus this eruption, externally reduced in cultivated countries to a common itch, could be much more easily removed from the skin through various means; so that with the medicinal external treatment since introduced, especially in the middle and higher classes, through baths, washes and ointments of sulphur and lead, and by preparations of copper, zinc and mercury, the external manifestations of Psora on the skin were often so quickly suppressed, and are so now, that in most cases either of children or of grown persons the history of itch infection may remain undiscovered.
But the state of mankind was not improved thereby; in many respects it grew far worse. For, although in ancient times the eruption of psora appearing as leprosy was very troublesome to those suffering from it, owing to the lancinating pains in, and the violent itching all around the tumors, and scabs, the rest of the body enjoyed a fair share of general health. This was owing to the obstinately persistent eruption on the skin which served as a substitute for the internal psora. And what is of more importance, the horrible and disgusting appearance of the lepers made such a terrible impression on healthy people that they dreaded even their approach; so that the seclusion of most of these patients, and their separation in leper hospitals, kept them apart from other human society and infection from them was thus limited and comparatively rare.
In consequence of the very much milder form of the psora during the fourteenth and fifteenth centuries, when it appeared as itch, the few pustules appearing after infection made but little show and could easily be concealed. Nevertheless they were scratched continually because of their unbearable itching, and thus the fluid was diffused around, and the psoric miasma was communicated more certainly and more easily to many other persons, the more it was concealed. For the things rendered unclean by the psoric fluid infected the persons who unwittingly touched them, and thus contaminated far more persons than the lepers, who, on account of their horrible appearance, were carefully avoided.
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PSORA has thus become the most infectious and most general of all the chronic miasmas. For the miasm has usually been communicated to others before the one from whom it emanates has asked for or received any external repressive remedy against his itching eruption (lead-water, ointment of the white precipitate of mercury), and without confessing that he had an eruption of itch, often even without knowing it himself; yea, without even the physician’s or surgeon’s knowing the exact nature of the eruption which has been repressed by the lotion of lead, etc.
It may well be conceived that the poorer and lower classes, who allow the itch to spread on their skin for a long time, until they become an abomination to all around them and are compelled to use something to remove it, must have in the meanwhile infected many.
Mankind, therefore, is worse off from the change in the external form of the psora, – from leprosy down to the eruption of itch – not only because this is less visible and more secret and therefore more frequently infectious, but also especially because the Psora, now mitigated externally into a mere itch, and on that account more generally spread, nevertheless still retains unchanged its original dreadful nature. Now, after being more easily repressed, the disease grows all the more unperceived within, and so, in the last three centuries, after the destruction* of its chief symptom (the external skin-eruption) it plays the sad role of causing innumerable secondary symptoms; i. e., it originates a legion of chronic diseases, the source of which physicians neither surmise nor unravel, and which, therefore, they can no more cure than they could cure the original disease when accompanied by its cutaneous eruption; but these chronic diseases, as daily experience shows, were necessarily aggravated by the multitude of their faulty remedies.
(*The external eruption of itch may not only be driven away by the faulty practices of physicians and quacks, but unfortunately it not infrequently of its own accord withdraws from the skin (see below, e.g., in the observation of the older physicians, Nos. 9, 17, 26, 36, 50, 58, 61, 64, 65). Syphilis and sycosis both have an advantage over the itch disease, in this, that the chancre (or bubo) in the one and the fig-wart in the other never leave the external until they have been either mischievously destroyed through external repressive remedies or have been in a rational manner removed through the simultaneous internal cure of the whole disease. The venereal disease cannot, therefore, break out so long as the chancre is not artificially destroyed by external applications, nor can the secondary ailments of sycosis break out so long as the fig-wart has not been destroyed by faulty practice; for these local symptoms, which act as substitutes for the internal disease, remain standing even until the end of man’s life, and prevent the breaking out of the internal disease. It is, therefore, just as easy to heal them then, even in their whole extent; i.e. thoroughly, through their specific internal medicines, which need only to be continued until these local symptoms (chancre and fig-wart) which are in their nature unchangeable except through artificial external application, are thoroughly healed. Then we may be quite certain that we have thoroughly cured the internal disease; i. e., syphilis and sycosis.
This good feature psora has lost in the present more and more mitigated nature of its chief symptom, which has changed from leprosy to itch in the last three centuries. The eruption of itch by no means remains as persistently in its place on the skin as the chancre and the fig-wart. Even if the eruption of itch has not (as is nearly always the case) been driven away from the skin through the faulty practices of physicians and quacks by means of desiccating washes, sulphur ointments, drastic purgatives or cupping, it frequently disappears, as we say, of itself; i. e., through causes which are not noticed. It often disappears through some unlucky physical or psychical occurrence, through a violent fright, through continual vexations, deeply-affecting grief, through catching a severe cold, or through a cold temperature (see below, observation 67); through cold, lukewarm and warm river baths or mineral baths, by a fever arising from any cause, or through a different acute disease. (e. g., smallpox; see below, observation 39); through persistent diarrhoea, sometimes also perhaps through a peculiar want of activity in the skin, and the results in such a case are just as mischievous as if the eruption had been driven away externally by the irrational practice of a physician. The secondary ailments of the internal psora and any one of the innumerable chronic diseases flowing from this origin will then break out sooner or later.
But let no one think that the psora which has been thus mitigated in its local symptom, its cutaneous eruption, differs materially from ancient leprosy. Even leprosy, when not inveterate, could in ancient times not seldom be driven from the skin by cold baths or by repeated dipping in a river and through warm mineral baths (see below, No. 35); but also then the evil effects resulting were as little regarded as the more modern physicians regard the acute diseases and the insidious maladies which do not fail to develop sooner or later from the indwelling psora when an eruption of the present itch disease has disappeared of itself or has been violently driven away).
So great a flood of numberless nervous troubles, painful ailments, spasms, ulcers (cancers), adventitious formations, dyscrasias, paralyses, consumptions and cripplings of soul, mind and body were never seen in ancient times when the Psora mostly confined itself to its dreadful cutaneous symptom, leprosy. Only during the last few centuries has mankind been flooded with these infirmities, owing to the causes just mentioned.*
(*That the drinking of warm coffee and Chinese tea which has spread so generally in the last two centuries, and which has so largely increased the irritability of the muscular fibre as well as the excessive excitability of the nerves, has further augmented the tendency of this period to a multitude of chronic diseases, and has thus aided the psora, I least of all can doubt, as I have made prominent, perhaps too prominent, the part which coffee takes with respect to the bodily and mental sufferings of humanity, in my little work on The Effects of Coffee (Die Wirkungen des Kaffee’s. Leipzig, 1803). This, perhaps undue, prominence given was owing to the fact that I had not then as yet discovered the chief source of chronic diseases in the psora. Only in connection with the excessive use of coffee and tea, which both offer palliatives for several symptoms of psora, could, psora spread such innumerable, such obstinate chronic sufferings among mankind; for psora alone could not have produced this effect.)
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It was thus that PSORA became the most universal mother of chronic diseases.
The psora, which is now so easily and so rashly robbed of its ameliorating cutaneous symptom, the eruption of itch, which acts vicariously for the internal disease, has been producing within the last three hundred years more and more secondary symptoms, and indeed so many that at least seven-eighths of all the chronic maladies spring from it as their only source, while the remaining eighth springs from syphilis and sycosis or from a complication of two of these three miasmatic chronic diseases, or (which is rare) from a complication of all three of them. Even syphilis, which on account of its easy curability yields to the smallest dose of the best preparation of mercury, and sycosis, which on account of the slight difficulty in its cure through a few doses of thuja and nitric acid in alternation, only pass into a tedious malady difficult to cure when they are complicated with psora. Thus PSORA is among all diseases the one which is most misapprehended, and, therefore, has been medically treated in the worst and most injurious manner.
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It is incredible to what an extent modern physicians of the common school have sinned against the welfare of humanity; since, with scarcely an exception, teachers of medicine and the more prominent modern physicians and medical writers have laid down the rule and taught it as an infallible theorem that: Every eruption of itch is merely a local ailment of the skin, in which ailment the remaining organism takes no part at all, so that it may and must be driven away from the skin at any time and without any scruple, through local applications of sulphur ointment or of the yet more active ointment of Jasser, through sulphur fumigations, by solutions of lead and zinc, but most quickly by the precipitates of mercury. If the eruption is once removed from the skin everything is well and the person is restored and the whole disease removed. Of course, if the eruption is neglected and allowed to spread upon the skin, then it may eventually turn out that the malignant matter may find opportunity to insinuate itself through the absorbent vessels into the mass of humors, and thus to corrupt the blood, the humors and the health. Then, indeed, man may finally be afflicted with ailments from these malignant humors, though these might soon again be removed from the body by purgatives and abluents; but through prompt removal of the eruption from the skin all sequelae are prevented, and the internal body remains entirely healthy.
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These horrible untruths have not only been, and are still being taught, but they are also carried out in practice. The consequence is that at the present day the patients in all the most celebrated hospitals, even in those countries and cities that seem most enlightened, as well as the private itch-patients of the lower and higher classes, the patients in all the penitentiaries and orphan asylums, in other civil and military hospitals, wherever such eruptions are found – in short, the innumerable multitude of patients, – without exception, are treated, not only by physicians unknown to fame, but by all, even those most celebrated, with the above mentioned external remedies,* using perhaps at the same time large doses of flowers of sulphur, and strong purgatives (to cleanse the body, as they say). These physicians think that the more quickly these eruptions are driven from the skin the better. Then they dismiss the patients from their treatment as cured, with brazen assurance and the declaration that everything is now all right, without regarding or being willing to notice the ailments which sooner or later are sure to follow; i. e., the Psora which shows itself from within in a thousand different diseases.** If the deceived wretches then sooner or later return with the malady following unavoidably on such a treatment; e. g., with swellings, obstinate pains in one part or another, with hypochondriac or hysterical troubles, gout, consumption, tubercular phthisis, continual or spasmodic asthma, blindness, deafness, paralysis, caries of the bones, ulcers (cancer), spasms, haemorrhages, diseases of the mind and soul, etc., the physicians imagine that they have before them something entirely new and treat it again and again according to the old routine of their therapeutics in a useless and hurtful manner, directing their medicines against phantom diseases; i. e., against causes invented by them for the ailments as they appear, until the patient, after many years’ suffering continually aggravated, is at last freed from their hands by death, the end of all earthly maladies.
(*Then, as these gentlemen dream in their perverted minds, in which they have disposed of the nature of this most important disease in their arbitrary way and without consulting nature, then these frivolous gentlemen assure us, the matter of the itch has not yet had time to penetrate inwardly and to be received by the absorbent vessels to the detriment of the whole mass of humors. But how then, 0 conscientious men! if even the first little pustule of itch with its unbearable voluptuous itching, forcing a man irresistibly to scratch, and with the following burning pain, is in every case and every time the proof of a universal itch-disease which has been previously developed in the interior of the whole organism, as we shall see below? How then, if in accordance with this fact any external repression of the, itch-eruption can not only do nothing toward alleviating the internal general disease, but rather as thousands of facts go to prove, compel it to develop and break forth quickly into innumerable, different, acute sufferings, or gradually into chronic sufferings, which make mankind so helpless and miserable? Can you then heal these? Experience says no; you cannot do it.)
(In some vigorous itch patients the vital force, following the law of nature on which it rests (her instinct showing more wisdom than the intelligence of her destroyers), after some weeks, drives back to the skin the eruption seemingly destroyed by itch ointments and purgatives; the patient returns to the hospital and the mischievous destruction of the eruption by means of ointments and lotions of solutions of lead and zinc, is renewed. I have seen in military hospitals this eruption thus destroyed in an irrational a cruel manner three times in succession within a few months, while the quack who applied the ointment pretended that the patient must have been infected anew with itch three times in this short period, which was really impossible.)
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(** I wrote this six years ago, but even at this day the physicians of the old school continue to act and teach with the same criminal negligence. In this most important medical affair they have up to this day not become the least bit wiser or more humane.)
(By accident (for they cannot give any but a feigned reason for their action) they found out a refuge which temporarily often alleviates the sufferings of their patients when they can not do anything at home with their prescriptions against the unknown diseases; that is, they send him to some sulphur bath or other, where the patients often get rid of a small part of their psora, and thus are also at the first use of the baths for a time relieved of their chronic disease; but afterwards they fall back into the same or a kindred ailment, and the repetition of the bath then avails little or nothing, because the cure of a developed Psora requires a far more adequate treatment than the impetuous use of such baths.)
The older physicians were more conscientious in this matter and observed with less prejudice. They saw clearly and became convinced that innumerable ailments and the most severe chronic diseases follow the destruction of the itch-eruption from the skin. And since this experience compelled them to assume the existence of an internal disease, in every case of itch they endeavored to extirpate this internal malady by means of a multitude of internal remedies, as good as their therapeutics afforded. It was, indeed, but a useless endeavor, because the true method of healing, which it could only be the prerogative of Homoeopathy to discover, was unknown to them. Nevertheless this sincere endeavor was praiseworthy, since it was founded on an appreciation of the great internal disease present together with the eruption of itch, which internal disease it was necessary to remove. This prevented their reliance on the mere local destruction of the itch from the skin, as practiced by modern physicians, who think that they cannot quickly enough drive it away as if it were a mere external disease of the skin-without regarding the great injuries attending such a course. The older physicians, on the other hand, have warningly laid these injuries before our eyes in their writings, giving thousands of examples.
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The observations of those honest men are too startling to be rejected contemptuously, or ignored by conscientious men.
I shall here adduce some of these numerous observations handed down to us, which I might increase by an equal number of my own if the former were not already abundantly sufficient to show with what fury the internal Psora manifests itself when the external local symptom which serves to assuage the internal malady is hastily removed. They also show that it must be a matter of conscience for the physician who loves his fellow-man to direct all his endeavors to cure, first of all, the internal malady, whereby the cutaneous eruption will at the same time be removed and destroyed and all the subsequent innumerable lifelong chronic sufferings springing from the Psora be prevented or, if they are already embittering the life of the patient, be cured.
The diseases, partly acute but chiefly chronic, springing from such a one-sided destruction of the chief skin-symptom (eruption and itching) which acts vicariously and assuages the internal Psora (which destruction is erroneously called Driving the itch into the body) are innumerable; as manifold as the peculiarities of bodily constitutions and of the outer world which modifies them.
A brief survey of the manifold misfortunes resulting thence is given by the experienced and honest LUDWIG CHRISTIAN JUNCKER in his Dissertalio de Damno ex Scabie Repulsa, Halle, 1750, p. 15-18. He observed that with young people of a sanguine temperament the suppression of itch is followed by phthisis, and with persons in general who are of a sanguine temperament it is followed by piles, haemorrhoidal colic and renal gravel; with persons of sanguino-choleric temperament by swellings of the inguinal glands, stiffening of the joints and malignant ulcers (called in German Todenbruche); with fat persons by a suffocating catarrh and mucous consumption; also by inflammatory fever, acute pleurisy and inflammation of the lungs. He further states that in autopsies the lungs have been found indurated and full of cysts containing pus; also other indurations, swellings of the bones and ulcers have been seen to follow the suppression of an eruption. Phlegmatic persons in consequence of such suppressions suffered chiefly from dropsy; the menses were delayed, and when the itch was driven away during their flow, they were changed into a monthly haemoptysis. Persons inclined to melancholy were sometimes made insane by such repression; if they were pregnant the foetus was usually killed. Sometimes the suppression of the itch causes sterility,* in nursing women the milk is generally lacking, the menses disappear prematurely; in older women the uterus becomes ulcerated, attended with deep, burning pains, with wasting away (cancer of the womb).
*A pregnant Jewess had the itch on her hands and drove it away in the eighth month of her pregnancy so that it might not be seen during the period of her delivery. Three days afterwards she was delivered and the lochial discharge did not appear and she was seized with a high fever; since that time for seven years she had been sterile and had suffered from leucorrhoea. Then she became poor and had to walk a great distance barefooted; hereupon the itch again appeared and she thus lost her leucorrhoea and her other hysteric affections; she became again pregnant and was safely delivered. (Juncker, ibid.)
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His experiences were frequently confirmed by the observations of others, as e. g. with reference to Asthma, Lentilius Miscell. med. pract. Tom. I., P. 176. Fr. Hoffmann Abhandlung v. d. Kinderkrankheitenn, Frft., 1741, P. 104. Detharding in Append. ad Ephem. Nat. Cur. Dec. III., ann 5 et 6 et in obs. parallel. ad obs. 58. Binninger, Obs. Cent. V., obs. 88. Morgagni, de sedibus et. caus. morb. Epist. XIV., 35. Acta Nat. Cur. Tom. V obs. 47. J. Juncker, Consp. ther. spec. tab. 31. F. H. L. Muzell, Wahrnehm. Samml. II. Cas. 8.1 J. Fr. Gmelin in Gesner’s Samml. v. Beob. V. S. 21.2 Hundertmark.-Zieger Dissert. de scabie artificiale, Lips. 1758, p. 32.3 Beireis-Stammen. Diss. de causis cur imprismis plebs scabie laboret. Helmst., 1792, P. 26.4 Pelargus (Storch) Obs. clin. Jahrg., 1722, P. 435 n 438.5 Breslauer Sammlung v. Jahre 1727, P, 293.6 Riedlin, the father, Obs. Cent. II., obs. 90. Augsburg, 1691.7
Suffocating Catarrh, Ehrenfr. Hagendorn, hist. med. phys. Cent. I., hist 8, 9.8 Pelargus, Obs. clin. Jahrg., 1723, P. 15.9
(When writing the fast edition of the Chronic Diseases, I was not as yet acquainted with Autenrieth’s Versuche fuer die prakt. Heilkunde aus den Klinishen Anstalten von Tubingen, 1808. But I saw on examining the work, that what he says about diseases following the driving away of itch through local applications is only a confirmation of what I had already found with the other hundred writers. He also had observed that the external driving away of itch was followed by ulcers on the feet, pulmonary consumption, hysterical chlorosis with various menstrual irregularities; white swelling of the knee, dropsy of the joints, epilepsy, amaurosis, with obscured cornea; glaucoma, with complete amaurosis; mental derangement, paralysis, apoplexy and curvature of the neck; these he erroneously attributed to the ointments alone. But his own slow local driving away of the eruption by means of sulphuret of potash and soft soap, which he in vain calls healing it, is in no way better. Just as if his treatment were anything else than a local driving away of the eruption from the skin! Of any true cure he knows just as little as the other Allopaths, for he writes: It is, of course, absurd to endeavor to cure itch (scab) by internal remedies. No! it is not only absurd, but even watched to undertake to cure an internal itch-disease which cannot be cured by any local application, through any but internal means, which alone can cure the disease thoroughly and with certainty.)
(1 A man 30 to 40 years of age had been afflicted with the itch a long time before, and it had been driven away by ointments; from which time he had become more and more asthmatic. His respiration became at last, even when not in motion, very short and extremely labored, emitting at the same time a continuous hissing sound, but attended with only little coughing. He was ordered an injection of one drachm of squills, and to take internally 3 grains of squills. But by mistake he took the drachm of squills internally. He was near losing his life with an indescribable nausea and retching. Soon after this the itch appeared again on his hands, his feet and his whole body in great abundance, and by this means the asthma was at once removed.)
(2 The violent asthma was combined with general swelling and fever.)
(3 A man of 32 years had the itch driven away by sulphur ointment, and he suffered for eleven months from the most violent asthma until by drinking birch-juice the eruption was brought back on the twenty-third day.)
(4 A student was seized with the itch just as he was going to dance, on which account he had it driven out by a practitioner with sulphur ointment. But soon after, he was attacked by such a severe asthma that he could only draw breath by throwing his head back, and was almost suffocated during the attacks. After thus wrestling with death for an hour, he would cough up little cartilaginous pieces which would ease him for a very short time. Having returned home to Osterode he suffered continually for two years of this disease, being attacked about ten times a day, which could not even be mitigated through the help of his physician, Beireis)
(5 A boy of 13 years having suffered from his childhood with tinea capitis had his mother remove it for him, but he became very sick within eight or ten days, suffering with asthma, violent pains in the limbs, back and knee, which were not relieved until an eruption of itch broke out over his whole body a mouth later.)
(6 Tinea capitis in a little girl was driven away by purgatives and other medicines, but the child was attacked with oppression of the chest, cough and great lassitude. It was not until she stopped taking the medicines, and the tinea broke out again, that she recovered her cheerfulness and this, indeed, quickly.)
(7 A boy of 5 years suffered for a long time from itch, and when this was driven away by a salve it left behind a severe melancholy with a cough.)
(8 Owing to tinea capitis, which had been driven off by rubbing with almond oil, there arose an excessive lassitude of all the limbs, headache on one side, loss of appetite, asthma, waking up at night with suffocating catarrh, with severe rattling and whistling on the chest and convulsive twisting of the limbs, as if about to die, and hematuria. When the tinea broke out again, he recovered from all these ailments.A 3-year-old girl had the itch, for several weeks; when this was driven out by an ointment she was seized the next day by a suffocating catarrh with snoring, and with numbness and coldness of the whole body, from which she did not recover until the itch re-appeared.)
(9 A girl of twelve years had the itch with which she had frequently suffered, driven away from the skin by an ointment, when she was seized with an acute fever with suffocative catarrh, asthma and swelling, and afterward with pleurisy. Six days afterward, having taken an internal medicine containing sulphur, the itch again appeared and all the ailments, excepting the swelling, disappeared but after twenty-four days the itch again dried up, which was followed by a new inflammation in the chest with pleurisy and vomiting.)