Nature of Chronic Diseases-4
by Samuel Hahnemann
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Hundertmark, as ab., P.32.89 Fr. Hoffrnann, Consult. med. I. Cas. 28, P.141.90
Apoplexy. Cummius in Eph. Nat. Cur. Dec I., ann. I, obs. 58. Mobius, Institut. med., P.65. J. J. Wepfer, Histor. Apoplect. Amstel., 1724, P.457.
Paralysis, Hoechstetter. Obs. med., dec. VIII., obs. 8, P.245. journal de Medorrhinum, 1760, Sept., P.211. Unzer, Arzt VI., St. 301.91 Hundertmark, as above, P.33.92 Krause. Schubert, Diss. de scabie humani corp., Lips., 1779, P.23.93 Karl Wenzel, as above, P.174.
Melancholy, Reil, memorab. Fasc., III., P.177.94
Insanity, Landais in Roux, journ. de Medecine, Tom. 41. Amat. Lusitanus, Curat. med. Cent. II., Cur. 74. J. H. Schulze, Brune, Diss. Casus aliquot mente alienatorm, Halle, 1707, Cas. I, P.5.95 F. H. Waitz, medic.-chirurg. Aufsatze, Th I, P.130.96 Altenburg, 1791. Richter in Hufel. Journal, XV., II. Grossmann in Baldinger’s neuem’, Magaz., XI., I.97
(89 The itch in a youth of 20 years was suppressed by a purgative which was allowed to act violently for several days, after which he for two years suffered daily the most violent convulsions, until, through the use of birch-juice, the itch was brought back to the skin.)
(90 A young mail of 17 years, of vigorous constitution and good intelligence, was attacked three years ago, after itch had been driven out, first by haemoptysis and then by epilepsy, which grew worse through medicines until the fits came on every two hours. Another surgeon, through frequent blood-lettings and many medicines, effected that he remained free from epilepsy for four weeks, but soon afterwards the epilepsy returned while he was taking his noonday nap, and the patient had two or three fits in the nights; at the same time he was attacked with a very severe cough and suffocating catarrh, especially during the nights, when he expectorated a very fetid fluid. He was confined to his bed. At last, after much medicine, the disease increased so much that he had ten fits at night and eight during the day. Nevertheless he never in these fits either clenched his thumbs or had foam at his mouth. His memory is weakened. The attacks come at the approach of meal-time, but more frequently after meals. During his nightly attacks he remains in the deepest sleep without awaking, but in the morning he feels as if bruised all over. The only warning of a fit consists in his rubbing his nose and drawing up his left foot, but then he suddenly falls down.)
(91 A woman, after having the itch driven out, had paralysis of one leg and remained lame.)
(92 After driving off the itch with sulphur ointment, a man of 53 years had hemiplegia.)
(93 A minister who for a long time had in vain used internal remedies against the itch finally grew tired of it and drove it off with ointment, when his upper extremities were, in a measure, paralyzed and a hard, thick skin formed in the palms of the hands, full of bloody chaps and insufferable itching.
In the same place the author mentions also a woman whose fingers contracted from an itch driven out by external means; she suffered of them a long time.)
(94 He found an idiotic melancholy arise in consequence of suppressed itch; when the itch broke out again the melancholy disappeared.)
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(95 A student, 20 years old, had the humid itch, which so covered his hands that he became incapable of attending to his work. It was driven off by sulphur ointment. But shortly after it appeared how much his health had suffered from it. He became insane, sang or laughed where it was unbecoming, and ran until he sank to the ground from exhaustion. From day to day he became more sick in soul and in body, until at last hemiplegy came on and he died. The intestines were found grown together into a firm mass, studded with little ulcers full of protuberances, some of the size of walnuts, which were filled, with a substance resembling gypsum.)
(96 The same story.)
(97 A man of 50 years with whom, after driving away the itch by ointments, general dropsy had set in; when the itch re-appeared and drove away the swelling he drove it away again, when he fell into raving madness, while head and neck swelled up to suffocation; at last blindness and complete suppression of urine were added. Artificial irritants applied to the skin and a strong emetic brought back the itch again; when the eruption extended over the whole body all the former accidents disappeared.)
Who, after meditating on even these few examples which might be much increased from the writings of the physicians of that time and from my experience,* would remain so thoughtless as to ignore the great evil hidden within, the Psora, of which evil the eruption of itch and its other forms, the tinea capitis, milk crust, tetter, etc., are only indications announcing the internal, monstrous disease of the whole organism, only local external symptoms which act vicariously and mitigatingly for the internal disease? Who, after reading even the few cases described, would hesitate to acknowledge that the Psora, as already stated, is the most destructive of all chronic miasmas? Who would be so stolid as to declare, with, the later allopathic physicians, that the itch-eruption, tinea and tetters are only situated superficially upon the skin and may, therefore, without fear, be driven out through external means since the internal of the body has no part in it and retains its health?
(* An opponent, of the old school, has reproached me that I have not adduced my own experience to prove that the chronic maladies, when they are not of syphilitic or sycotic origin, spring from the miasma of itch, as such proofs from experience would have been convincing. Oho! If the examples here adduced by me from both the older and from modern non-Homoeopathic writings have not yet enough convincing proof, I should like to know what other examples (even my own not excepted) could be conceived of as more striking proofs? How often (and I might say almost always) have opponents of the old school refused all credence to the observations of honorable Homoeopathic physicians, because they were not made before their own eyes and because the names of the patients were only indicated with a letter; as if private patients would allow their names to be used! Why should I endure the like? And do I not prove my point in a manner most indubitable and most free from partisanship through the experience of so many other honest practitioners?)
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Surely, among all the crimes which the modem physicians of the old school are guilty of, this is the most hurtful, shameful and unpardonable!
The man who, from the examples given and from innumerable others of a like nature, is not willing to see the exact opposite of that assertion blinds himself on purpose and works intentionally for the destruction of mankind.
Or are they so little instructed as to the nature of all the miasmatic maladies connected with diseases of the skin that they do not know that they all take a similar course in their origin? And that all such miasmas become first internal maladies of the whole system before their external assuaging symptom appears on the skin?
We shall more closely elucidate this process, and in consequence we shall see that all miasmatic maladies which show peculiar local ailments on the skin are always present as internal maladies in the system before they show their local symptom externally upon the skin; but that only in acute diseases, after taking their course through a certain number of days, the local symptom, together with the internal disease, is wont to disappear, which then leaves the body free from both. In chronic miasmas, however, the outer local symptom may either be driven from the skin or may disappear of itself, while the internal disease, if uncured, neither wholly nor in part ever leaves the system; on the contrary, it continually increases with the years, unless healed by art.
I must here dwell the more circumstantially on this process of nature, because the common physicians, especially of modem days, are so deficient in vision; or, more correctly stated, so blind that although they could, as it were, handle and feel this process in the origin and development of acute miasmatic eruptional diseases, they nevertheless neither surmised nor observed the like process in chronic diseases, and therefore declared their local symptoms as secondary growths and impurities existing merely externally on the skin, without any internal fundamental disease, and this as well with the chancre and the fig-wart as with the eruption of itch, and fore – since they overlooked the chief disease or perhaps even boldly denied it – by a mere external treatment and destruction of these local ailments they have brought unspeakable misfortunes on suffering humanity.
With respect to the origin of these three chronic maladies, as in the acute, miasmatic eruptional diseases, three different important moments are to be more attentively considered than has hitherto been done: First, the time of infection; secondly, the period of time during which the whole organism is being penetrated by the disease infused, until it has developed within; and thirdly, the breaking out of the external ailment, whereby nature externally demonstrates the completion of the internal, development of the miasmatic malady throughout the whole organism.
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The infection with miasmas, as well of the acute as of the above-mentioned chronic diseases, takes place, without doubt, in one single moment, and that moment, the one most favorable for infection.
When the smallpox or the cowpox catches, this happens in the moment when in vaccination the morbid fluid in the bloody scratch of the skin comes in contact with the exposed nerve, which then, irrevocably, dynamically communicates the disease to the vital force (to the whole nervous system) in the same moment. After this moment of infection no ablution, cauterizing or burning, not even the cutting off of the part which has caught and received the infection, can again destroy or undo the development of the disease within. Smallpox, cowpox, measles, etc., nevertheless will complete their course within, and the fever peculiar to each will break out with its smallpox, cowpox, measles,* etc., after a few days, when the internal disease has developed and completed itself.
The same is the case, not to mention several other acute miasmas, also when the skin of man is contaminated with the blood of cattle affected with anthrax. If, as is frequently the case, the anthrax has infected and caught on, all ablutions of the skin are in vain; the black or gangrenous blister, nearly always fatal, nevertheless, always comes out after four or five days (usually in the affected spot); i.e., as soon as the whole living organism has transformed itself to this terrible disease.
(*We may justly ask: Is there in any probability any miasma in the world, which, when it has infected from without, does not first make the whole organism sick before the signs of it externally manifest themselves? We can only answer this question with, no, there is none!
Does it not take three, four or five days after vaccination is effected, before the vaccinated spot becomes inflamed? Does not the sort of fever developed – the sign of the completion of the disease-appear even later, when the protecting pock has been fully formed; i.e., on the seventh or eighth day?
Does it not take ten to twelve days after infection with smallpox, before the inflammatory fever and the outbreak of the smallpox on the skin take place?
What has nature been doing with the infection received in these ten or twelve days? Was it not necessary to first embody the disease in the whole organism before nature was enabled to kindle the fever, and to bring out the eruption on the skin?
Measles also require ten or twelve days after infection or inoculation before this eruption with its fever appears. After infection with scarlet fever seven days usually pass before the scarlet fever, with the redness of the skin, breaks out.
What then did nature do with the received miasma during the intervening days? What else but to incorporate the whole disease of measles or scarlet fever in the entire living organism before she had completed the work, so as to be enabled to produce the measles and the scarlet fever with their eruption.)
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(It is just so with the infection of half-acute miasmas without eruption. Among many persons bitten by mad dogs – thanks to the benign ruler of the world only few are infected, rarely the twelfth; often, as I myself have observed, only one out of twenty or thirty persons bitten. The others, even if ever so badly mangled by the mad dog, usually all recover, even if they are not treated by a physician or surgeon.*) But with whomsoever the poison acts, it has taken effect in the moment when the person was bitten, and the poison has then communicated itself to the nearest nerves and, therefore, without contradiction, to the whole system of the nerves, and as soon as the malady has been developed in the whole organism (for this development and completion of the disease nature requires at least several days, often many weeks), the madness breaks out as an acute, quickly fatal disease. Now if the venomous spittle of the mad dog has really taken effect, the infection usually has taken place irrevocably in the moment of contagion, for experience shows that even the immediate excision and amputation of the infected part does not protect from the progression of the disease within, nor from the breaking out of the hydrophobia – therefore, also, the many hundreds, of other much lauded external means for cleansing, cauterizing and suppurating the wound of the bite can protect just as little from the breaking out of the hydrophobia.
From the progress of all these miasmatic diseases we may plainly see that, after the contagion from without, the malady connected with it in the interiors of the whole man must first be developed; i.e., the whole interior man must first have become thoroughly sick of smallpox, measles or scarlet fever, before these various eruptions can appear on the skin.
(*We are indebted especially to the careful English and American physicians for these comforting experiences – to HUNTER and HOULSTON (in London Medorrhinum Journal, Vol. 1.), and to VAUGHAN, SHADWELL and PERCIVAL., whose observations are recorded in jam. Mease’s On the Hydrophobia, Philadelphia, 1793.)
(An eight-year-old girl, in Glasgow, was bitten by a mad dog on the 21st of March, 1792. A surgeon immediately, exsected the wound altogether, kept it suppurating and gave mercury until it produced a mild salivation, which was kept tip for two weeks; nevertheless hydrophobia broke out on the 27th of April and the patient died on the 29th of April. M. DUNCAN’S Medorrhinum Comment, Dec. II., Vol. VII., Edinb. 1793, and The New London Medorrhinum journ., II.)
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For all these acute miasmatic diseases the human constitution possesses that process which, as a rule, is so beneficent: to wipe them out (i.e., the specific fever together with the specific eruption) in the course of from two to three weeks, and of itself to extinguish than again, through a kind of decision (crisis), from the organism, so that man then is wont to be entirely healed of them and, indeed, in a short time, unless he be killed by them.*
In the chronic miasmatic diseases nature observes the same course with respect to the mode of contagion and the antecedent formation of the internal disease, before the external declarative symptoms of its internal completion manifests itself on the surface of the body; but then that great remarkable difference from the acute diseases shows itself, that in the chronic miasmata the entire internal disease, as we have mentioned before, remains in the organism during the whole life, yea, it increases with every year, if it is not exterminated and thoroughly cured by art.
Of these chronic miasmata I shall for this purpose only adduce those two, which we know somewhat more exactly; namely, the venereal chancre and the itch.
In impure coition there arises, most probably at the very moment in the spot which is touched and rubbed, the specific contagion.
If this contagion has taken effect, then the whole living body is in consequence seized with it. Immediately after the moment of contagion the formation of the venereal disease in the whole of the
In that part of the sexual organs where the infection has taken place, nothing unnatural is noticed in the first days, nothing diseased, inflamed or corroded; so also all washing. and cleansing of the parts immediately after the impure coition is in vain. The spot remains healthy according to appearance, only the internal organism is called into activity by the infection (which occurs usually in a moment), so as to incorporate the venereal miasma and to become thoroughly diseased with the venereal malady.
(* Or have these various, acute, half-spiritual miasmas the peculiar characteristic that – after, they have penetrated the vital force in the first moment of the contagion (and each one in its own way has produced disease) and them, like parasites, have quickly grown up within it and have usually developed themselves by their peculiar fever, after producing their fruit (the mature cutaneous eruption which is again capable of producing its miasma) – they again die out and leave the living organism again free to recover?
On the other hand, are not the chronic miasmas disease-parasites which continue to live as long as the man seized by them is alive, and which have their fruit in the eruption originally produced by them (the itch-pustule, the chancre and the fig-wart, which in turn are capable of infecting others and which do not die off of themselves like the acute miasmas, but can only be exterminated and annihilated by a counter-infection, by means of the potency of a medicinal disease quite similar to it and stronger than it (the anti-psoric), so that the patient is delivered from them and recovers his health?)
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Only when this penetration of all the organs by the disease caught has been effected, only when the whole being has been changed into a man entirely venereal, i.e., when the development of the venereal disease has been completed, only then diseased nature endeavors to mitigate the internal evil and to soothe it, by producing a local symptom which first shows itself as a vesicle (usually in the spot originally infected), and later breaks out into a painful ulcer called the chancre; this does not appear before five, seven or fourteen days, sometimes, though rarely, not before three, four or five weeks after the infection. This is therefore manifestly a chancre ulcer which acts vicariously for the internal malady, and which has been produced from within by the organism after it has become venereal through and through, and is able through its touch to communicate also to other men the same miasma; i.e., the venereal disease.
Now, if the entire disease thus arising is again extinguished through the internally given specific remedy, then the chancre also is healed and the man recovers.
But if the chancre is destroyed through local applications* before the internal disease is healed, – and this is still a daily practise with physicians of the old school, – the miasmatic chronic venereal remains in the organism as syphilis, and it is aggravated, if not then cured internally, from year to year until the end of man’s life, the most robust constitution being unable to annihilate it within itself.
Only through the cure of the venereal disease, which pervades the whole internal of the body (as I have taught and practiced for many years), the chancre, its local symptom, will also simultaneously be cured in the most effective manner; and this is best without the use of any external application for its removal – while the merely local destruction of the chancre, without any previous general cure and deliverance of man from the internal disease, is followed by the most certain outbreak of syphilis with its sufferings.
(*The venereal disease not only breaks out through the removal of the chancre by the cautery, – in which case some wretched casuists have considered syphilis as resulting from the driving back of the poison out of the chancre into the interior of the body, which up to this time is supposed by them to have been healthy, – no, even after the quick removal of the chancre without any external stimulants, the venereal disease breaks out, which gives additional conformation, if this were needed, of the indubitable pre-existence of syphilis in the system. Petit cut off a part of the labia minora, in which for some days a venereal chancre had appeared; the wound healed, indeed, but the venereal disease broke out notwithstanding. M. s. Fabre, Lettres, supplement Ã son traitÃ© des maladies vÃ©nÃ©riennes, Paris, 1786. Of course! because the venereal disease was present in the whole interior of the body even before the outbreak of the chancre.
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Psora (itch disease), like syphilis, is a miasmatic chronic disease, and its original development is similar.
The itch disease is, however, also the most contagious of all chronic miasmata, far more infectious than the other two chronic miasmata, the venereal chancre disease and the figwart disease. To effect the infection with the latter there is required a certain amount of friction in the most tender parts of the body, which are the most rich in nerves and covered with the thinnest cuticle, as in the genital organs, unless the miasma should touch a wounded spot. But the miasma of the itch needs only to touch the general skin, especially with tender children. The disposition of being affected with the miasma of itch is found with almost everyone and under almost all circumstances, which is not the case with the other two miasmata.
No other chronic miasma infects more generally, more surely, more easily and more absolutely than the miasma of itch; as already stated, it is the most contagious of all. It is communicated so easily, that even the physician, hurrying from one patient to another, in feeling the pulse has unconsciously * inoculated other patients with it; wash which is washed with wash infected with the itch; new gloves which had been tried on by an itch patient, a strange lodging place, a strange towel used for drying oneself have communicated this tinder of contagion; yea, often a babe, when being born, is infected while passing through the organs of the mother, who may be infected (as is not infrequently the case) with this disease; or the babe receives this unlucky infection through the hand of the midwife, which has been infected by another parturient woman (or previously); or, again, a suckling may be infected by its nurse, or, while on her arm, by her caresses or the caresses of a strange person with unclean hands; not to mention the thousands of other possible ways in which things polluted with this invisible miasma may touch a man in the course of his life, and which often can in no way be anticipated or guarded against, so that men who have never been infected by the psora are the exception. We need not to hunt for the causes of infection in crowded hospitals, factories, prisons, or in orphan houses, or in the filthy huts of paupers; even in active life, in retirement, and in the rich classes, the itch creeps in. The hermit on Montserrat escapes it as rarely in his rocky cell, as the little prince in his swaddling clothes of cambric.
(* CAR. MUSITANI, Opera de tumoribus, Cuprum 20.)
(As WILLIS has noticed in TURNER, des maladies de la peau, traduit de l’anglais, Ã Paris, 1783, Tom. II., Cap. 3, P.77.)
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As soon as the miasma of itch, e. g., touches the hand, in the moment when it has taken effect, it no more remains local. Henceforth all washing and cleansing of the spot avail nothing. Nothing is seen on the skin during the first days; it remains unchanged, and, according to appearance, healthy. There is no eruption or itching to be noticed on the body during these days, not even on the spot infected. The nerve which was first affected by the miasma has already communicated it in an invisible dynamic manner to the nerves of the rest of the body, and the living organism has at once, all unperceived, been so penetrated by this specific excitation, that it has been compelled to appropriate this miasma gradually to itself until the change of the whole being to a man thoroughly psoric, and thus the internal development of the psora, has reached completion.
Only when the whole organism feels itself transformed by this peculiar chronic-miasmatic disease, the diseased vital force endeavors to alleviate and to soothe the internal malady through the establishment of a suitable local symptom on the skin, the itch-vesicles. So long as this eruption continues in its normal form, the internal psora, with its secondary ailments, cannot break forth, but must remain covered, slumbering, latent and bound.
Usually it takes six, seven or ten, perhaps even fourteen days from the moment of infection before the transformation of the entire internal organism into psora has been effected. Then only, there follows after a slight or more severe chill in the evening and a general heat, followed by, perspiration in the following night, (a little fever which by many persons is ascribed to a cold and therefore disregarded), the outbreak of the vesicles of itch, at first fine as if from miliary fever, but afterwards enlarging on the skin* – first in the region of the spot first infected, and, indeed, accompanied with a voluptuously tickling itching – which may be called unbearably agreeable (Grimmen), which compels the patient so irresistibly to rub and to scratch the vesicles of itch, that, if a person restrains himself forcibly from rubbing or scratching, a shudder passes over the skin of the whole body. This rubbing and scratching indeed satisfies somewhat for a few moments, but there then follows immediately a long- continued burning of the part affected. Late in the evening and before midnight this itching is most frequent and most unbearable.
(* Far from being an independent, merely local, cutaneous disease the vesicles or pustules of itch are the reliable proof that the completion of the internal psora has already been effected, and the eruption is merely an integrating factor of the same; for this peculiar eruption and this peculiar itching make a part of the essence of the whole disease in its natural, least dangerous state.)
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The vesicles of itch contain in the first hours of their formation a lymph clear as water, but this quickly changes into pus, which fills the tip of the vesicle.
The itching not only compels the patient to rub, but on account of its violence, as before mentioned, to rub and scratch open the vesicles; and the humor pressed out furnishes abundant material for infecting the surroundings of the patient and also other persons not yet infected. The extremities defiled even to an imperceptible degree with this lymph, so also the wash, the clothes and the utensils of all kinds, when touched, propagate the disease.
Only this skin symptom of the psora which has permeated the whole organism (and which as more manifestly falling under the cognizance of the senses has the name of itch), only this eruption, as well as the sores which later arise from it and are attended on their borders with the itching peculiar to psora, as also the herpes which has this peculiar itching and which becomes humid when rubbed (the tetter), as also the tinea capitis – these alone can propagate this to other persons, because they alone contain the communicable miasma of the psora. But the remaining secondary symptoms of the psora, which in time manifest themselves after the disappearance or the artificial expulsion of the eruption, i.e., the general psoric ailments, cannot at all communicate this disease to others. They are, so far as we know, just as little able to transfer the psora to others, as the secondary symptoms of the venereal disease are able to infect other men (as first observed and taught by J. HUNTER) with syphilis.
When the itch-eruption has only lately broken out and is not yet widely spread on the skin, nothing of the general internal malady of the psora is as yet to be noticed in the state of the patient. The emotional symptom acts as a substitute for the internal malady and keeps the psora with its secondary ailments as it were latent and confined.*
In this state, the disease is most easily cured through specific remedies internally administered.
But if the disease is allowed to advance in its peculiar course without the use of an internal curative remedy or an external application to drive away the eruption, the whole disease within rapidly increases, and this increase of the internal malady makes necessary a corresponding increase of the skin-symptom. The itch-eruption, therefore, in order to be able to soothe and to keep latent the increased internal malady, has to spread and must finally cover the whole surface of the body.
(* As also the chancre, when not expelled, acts vicariously and soothingly for the syphilis within, and does not permit the venereal disease to break out, so long as it remains undisturbed in its place. I examined a woman who was free from all the secondary symptoms of the venereal disease; with her a chancre had remained in its place untreated for two years, and had gradually acquired the size of almost an inch in diameter. The best preparation of Mercury, internally administered soon and entirely healed, not only the internal malady, but also the chancre.)