Psora – 4
by Samuel Hahnemann
—– Page – 120 —–
But if these aggravated original symptoms appear on subsequent days still of the same strength as at the beginning, or even with an increased severity, it is a sign that the dose of this antipsoric remedy, although properly selected according to homoeopathic principles, was too large, and it is to be apprehended that no cure will be effected by it; because the medicine in so large a dose is able to establish a disease, which in some respects, indeed, is similar to it; with respect to the fact, however, that the medicine in its present intensity unfolds also its other symptoms which annul the similarity, it produces a similar chronic disease instead of the former, and, indeed, a more severe and troublesome one, without thereby extinguishing the old original one.
This will be decided in the first sixteen, eighteen or twenty days of the action of the medicine which has been given in too large a dose, and it must then be checked, either by prescribing its antidote, or, if this is not as yet known, by giving another antipsoric medicine fitting as well as possible, and indeed in a very moderate dose, and if this does not suffice to extinguish this injurious medicinal disease, another still should be given as homoeopathically suitable as possible.*
Now when the stormy assault caused by too large a dose of medicine, although homoeopathically selected, has been assuaged through an antidote or the later use of some other antipsoric remedies, then, later on, the same antipsoric remedy – which had been hurtful only because of its over-large dose – can be used again, and, indeed, as soon as it is homoeopathically indicated, with the greatest success, only in a far smaller dose and in a much more highly potentized attenuation, i.e., in a milder quality.
The physician can, indeed, make no worse mistake than first, to consider as too small the doses which I (forced by experience) have reduced after manifold trials and which are indicated with every antipsoric remedy and secondly, the wrong choice of a remedy, and thirdly, the hastiness which does not allow each dose to act its full time.
(* I have myself experienced this accident, which is very obstructive to a cure and cannot be avoided too carefully. Still ignorant of the strength of its medicinal power, I gave sepia in too large a dose. This trouble was still more manifest when I gave lycopodium and silicea, potentized to the one-billionth degree, giving four to six pellets, though only as large as poppy seeds. Discite moniti.)
—– Page – 121 —–
The first error I have already spoken of, and would only add that nothing is lost if the dose is given even smaller than I have prescribed. It can hardly be given too small, if only everything ill the diet and the remaining mode of life of the patient which would obstruct or counteract the action of the medicine is avoided. The medicine will still produce all the good effects which can at all be expected from a medicine, if only the antipsoric was homoeopathically, correctly, selected according to the carefully investigated symptoms of the disease, and if the patient does not disturb its effects by his violation of the rules. If ever it should happen that the choice has not been correctly made, the great advantage remains, that the incorrectly selected medicine in this smallest dose may in the manner indicated above be counteracted more easily, whereupon the cure may be continued without delay with a more suitable antipsoric.
As to the second chief error in the cure of chronic diseases (the unhomoeopathic choice of the medicine) the homoeopathic beginner (many, I am sorry to say, remain such beginners their life long) sins chiefly through inexactness, lack of earnestness and through love of ease.
With the great conscientiousness which should be shown in the restoration of a human life endangered by sickness more than in anything else, the Homoeopath, if he would act in a manner worthy of his calling, should investigate first the whole state of the patient, the internal cause as far as it is remembered, and the cause of the continuance of the ailments his mode of life, his quality as to mind, soul and body, together with all his symptoms (see directions in Organon), and then he should carefully find out in the work on Chronic Diseases as well as in the work on Materia Medica Pura a remedy covering in similarity, as far as possible, all the moments, or at least the most striking and peculiar ones, with its own peculiar symptoms; and for this purpose he should not be satisfied with any of the existing repertories, – a carelessness only too frequent; for these books are only intended to give light hints as to one or another remedy that might be selected, but they can never dispense him from making the research at the first fountain heads. He who does not take the trouble of treading this path in all critical and complicated diseases, and, indeed, with all patience and intelligence, but contents himself with the vague hints of the repertories in the choice of a remedy, and who thus quickly dispatches one patient after the other, does not deserve the honorable title of a genuine Homoeopath, but is rather to be called a bungler, who on that account has continually to change his remedies until the patient loses patience; and as his ailments have of course only been aggravated he must leave this aggravator of diseases, whereby the art itself suffers discredit instead of the unworthy disciple of art.
—– Page – 122 —–
This disgraceful love of ease (in the calling which demands the most conscientious care) often induces such would-be Homoeopaths to give their medicines merely from the (often problematic) statement of their use (ab usu in morbis) which are enumerated in the introductions to the medicines, a method which is altogether faulty and strongly savors of allopathy, as these statements usually only give a few symptoms. They should only serve as a confirmation of a choice made according to the pure actions of the medicines; but never to determine the selection of a remedy which can cure only when used according to the exact similitude of its homoeopathic symptoms. There are, we are sorry to say, even authors who advise following this empiric pathway of error!
The third leading mistake which the homoeopathic physician cannot too carefully nor too steadfastly avoid while treating chronic diseases, is in hastily and thoughtlessly – when a properly moderate dose of a well selected antipsoric medicine has been serviceable for several days, – giving some other medicine in the mistaken supposition that so small a dose could not possibly operate and be of use more than eight or ten days. This notion is sought to be supported by the statement that on some day or other, while allowed to continue its action, the morbid symptoms which were to be eradicated, had shown themselves somewhat from time to time.
But if once a medicine, because it was selected in a correct homoeopathic manner, is acting well and usefully, which is seen by the eighth or tenth day, then an hour or even half a day may come when a moderate homoeopathic aggravation again takes place. The good results will not fail to appear but may, in very tedious ailments, not show themselves in their best light before the twenty-fourth or thirtieth day. The dose will then probably have exhausted its favorable action about the fortieth or fiftieth day, and before that time it would be injudicious, and an obstruction to the progress of the cure, to give any other medicine. Let it not be thought, however, that we should scarcely wait for the time assigned as the probable duration of action to elapse, before giving another antipsoric medicine: that we should hasten to change to a new medicine in order to finish the cure more quickly. Experience contradicts this notion entirely, and teaches on the contrary, that a cure cannot be accomplished more quickly and surely than by allowing the suitable antipsoric to continue its actions so long as the improvement continues, even if this should be several, yea, many* days beyond the assigned, supposed time of its duration, so as to delay as long as practicable the giving of a new medicine.
(* In a case where sepia had showed itself completely homoeopathically antipsoric for a peculiar headache that appeared in repeated attacks, and where the ailment had been diminished both as to intensity and duration, while the pauses between the attacks had also been much lengthened, when the attacks re-appeared I repeated the dose, which then caused the attacks to cease for one hundred days (consequently its action continued that long), when it reappeared to some degree, which necessitated another dose, after which no other attack took place for, now, seven years, while the health was also otherwise perfect.)
—– Page – 123 —–
Whoever can restrain his impatience as to this point, will reach his object the more surely, and the more certainly. Only when the old symptoms, which had been eradicated or very much diminished by the last and the preceding medicines commence to rise again for a few days, or to be again perceptibly aggravated, then the time has most surely come when a dose of the medicine most homoeopathically fitting should be given. Experience and careful observation alone can decide; and it always has decided in my manifold, exact observations, so as to leave no doubt remaining.
Now if we consider the great changes which must be effected by the medicine in the many, variously composite and incredibly delicate parts of our living organism, before a chronic miasm so deeply inrooted and, as it were, parasitically interwoven with the economy of our life as psora is, can be eradicated and health be thus restored: then it may well be seen how natural it is, that during the long-continued action of a dose of antipsoric medicine selected homoeopathically, assaults may be made by it at various periods on the organism, as it were in undulating fluctuations during this long-continued disease. Experience shows that when for several days there has been an improvement, half hours or whole hours or several hours will again appear when the case seems to become worse; but these periods, so long as only the original ailments are renewed and no new, severe symptoms present themselves, only show a continuing improvement, being homoeopathic aggravations which do not hinder but advance the cure, as they are only renewed beneficent assaults on the disease, though they are wont to appear at times sixteen, twenty or twenty-four days after taking a dose of antipsoric medicine.
(These attacks, however, if the antipsoric remedy was selected fittingly and homoeopathically and the dose was a moderate one, during its continued action take place, ever more and more rarely and more feebly, but if the doses were too strong they come more frequently and more strongly, to the detriment of the patient.)
—– Page – 124 —–
As a rule, therefore, the antipsoric medicine in chronic diseases continue their action the longer, the more tedious the diseases are. But vice versa also those medicines which in the healthy body show a long period of action act only a short time and quickly in acute diseases which speedily run their course (e.g. belladonna, sulphur, arsenic, etc.) and their periods of action are shorter, the more acute the diseases. The physician must, therefore, in chronic diseases, allow all antipsoric remedies to act thirty, forty or even fifty and more days by themselves, so long as they continue to improve the diseased state perceptibly to the acute observer, even though gradually; for so long the good effects continue with the indicated doses and these must not be disturbed and checked by any new remedy.*
(* The importance of avoiding the above-described two errors will hardly be realized by physicians. These great, pure truths will be questioned yet for years even by most of the homoeopathic physicians, and will not, therefore, be practiced, on account of the theoretical reflection and the reigning thought: It requires quite an effort to believe that so little a thing, so prodigiously small a dose of medicine, could effect the least thing in the human body, especially in coping with such enormously great, tedious diseases; but that the physician must cease to reason, if he should believe that these prodigiously small doses can act not only two or three days, but even twenty, thirty and forty days and longer yet, and cause, even to the last day of their operation, important, beneficent effects otherwise unattainable. Nevertheless this true theorem is not to be reckoned among those which should be comprehended, nor among those for which I ask a blind faith. I demand no faith at all, and do not demand that anybody should comprehend it. Neither do I comprehend it; it is enough, that it is a fact and nothing else. Experience alone declares it, and I believe more in experience than in my own intelligence. But who will arrogate to himself the power of weighing the invisible forces that have hitherto been concealed in the inner bosom of nature, when they are brought out of the crude state of apparently dead matter through a new, hitherto undiscovered agency, such as is potentizing by long continued trituration and succussion. But he who will not allow himself to be convinced of this and who will not, therefore, imitate what I now teach after many years’ trial and experience (and what does the physician risk, if he imitates it exactly?), he who is not willing to imitate it exactly, can leave this greatest problem of our art unsolved, he can also leave the most important chronic diseases uncured, as they have remained unhealed; indeed, up to the time of my teaching. I have no more to say about this. It seemed to me my duty to publish the great truths to the world that needs them, untroubled as to whether people can compel themselves to follow them exactly or not. If it is not done with exactness, let no one boast to have imitated me, nor expect a good result.
Do we refuse to imitate any operation until the wonderful forces of nature on which the result is based are clearly brought before our eyes and made comprehensible even to a child? Would it not be silly to refuse to strike sparks from the stone and flint, because we cannot comprehend how so much combined caloric can be in these bodies, or how this can be drawn out by rubbing or striking, so that the particles of steel which are rubbed off by the stroke of the hard stone are melted, and, as glowing little balls, cause the tinder to catch fire? And yet we strike fire with it, without understanding or comprehending this miracle of the inexhaustible caloric hidden in the cold steel, or the possibility of calling it out with a frictional stroke. Again, it would be just as silly as if we should refuse to learn to write, because we cannot comprehend how one man can communicate his thought to another through pen, ink, and paper – and yet we communicate our thoughts to a friend in a letter without either being able or desirous of comprehending this psychico-physical miracle! Why, then, should we hesitate to conquer and heal the bitterest foes of the life of our fellowman, the Chronic diseases, in the stated way, which, punctually followed, is the best possible method, because we do not see how these cures are effected?)
—– Page – 125 —–
But if these appropriately selected antipsoric medicines are not allowed to act their full time, when they are acting well, the whole treatment will amount to nothing. Another antipsoric remedy which may be ever so useful, but is prescribed too early and before the cessation of the action of the present remedy, or a new dose of the same remedy which is still usefully acting, can in no case replace the good effect which has been lost through the interruption of the complete action of the preceding remedy, which was acting usefully, and which can hardly be again replaced.
It is a fundamental rule in the treatment of chronic diseases: To let the action of the remedy, selected in a mode homoeopathically appropriate to the case of disease which has been carefully investigated as to its symptoms, come to an undisturbed conclusion, so long as it visibly advances the care and the while improvement still perceptibly progresses. This method forbids any new prescription, any interruption by another medicine and forbids as well the immediate repetition of the same remedy. Nor can there be anything more desirable for the physician than to see the improvement of the patient proceed to its completion unhindered and perceptibly. There are not a few cases, where the practiced careful Homoeopath sees a single dose of his remedy, selected so as to be perfectly homoeopathic, even in a very severe chronic disease, continue uninterruptedly to diminish the ailment for several weeks, yea, months, up to recovery; a thing which could not have been expected better in any other way, and could not have been effected by treating with several doses or with several medicines. To make the possibility of this process in some way intelligible, we may assume, what is not very unlikely, that an antipsoric remedy selected most accurately according to homoeopathic principles, even in the smallest dose of a high or the highest potency can manifest so long-continued a curative force, and at last cure, probably, only by means of a certain infection with a very similar medicinal disease which overpowers the original disease, by the process of nature itself, according to which (Organon, § 5, Fifth Edition,) two diseases which are different, indeed, in their kind but very similar in their manifestations and effects, as also in the ailments and symptoms caused by it, when they meet together in the organism, the stronger disease (which is always the one caused by the medicine, §33, ibid.) destroys the weaker (the natural one). In this case every new medicine and also a new dose of the same medicine, would interrupt the work of improvement and cause new ailments, an interference which often cannot be repaired for a long time.
—– Page – 126 —–
But if any unfavorable effects are evolved by the present dose of medicine, i.e., troublesome symptoms which do not belong to this disease, and if the mind of the patient becomes depressed, if only a little at first, still increasingly, then the next dose of the same medicine, given immediately after the former, cannot but become injurious to the patient. Yet when a sudden great and striking improvement of a tedious great ailment follows immediately on the first dose of a medicine, there justly arises much suspicion that the remedy has only acted palliatively, and therefore must never be given again, even after the intervention of several others remedies.
Nevertheless there are cases which make an exception to the rule, but which not every beginner should risk finding out.*
(* Still there has been of late much abuse of this immediate repetition of doses of the same medicine, because young Homoeopaths thought it more convenient to repeat, without examination, a medicine which in the beginning had been found to be homoeopathically suitable, and which had therefore in the beginning proved serviceable, and even to repeat it frequently without examination, so as to heal more quickly.
We may declare it once, that the practice of late, which has even been recommended in public journals of giving the patient several doses of the same medicine to take with him, so that he may take them himself at certain intervals, without considering whether this repetition may affect him injuriously, seems to show a negligent empiricism, and to be unworthy of a homoeopathic physician, who should not allow a new dose of a medicine to be taken or given without convincing himself in every case beforehand as to its usefulness.)
—– Page – 127 —–
The only allowable exception for an immediate repetition of the same medicine is when the dose of a well-selected and in every way suitable and beneficial remedy has made some beginning toward an improvement, but its action ceases too quickly, its power is too soon exhausted, and the cure does not proceed any further. This is rare in chronic diseases, but in acute diseases and in chronic diseases that rise into an acute state it is frequently the case. It is only then, as a practiced observer may recognize – when the peculiar symptoms of the disease to be treated, after fourteen, ten, seven, and even fewer days, visibly cease to diminish, so that the improvement manifestly has come to a stop, without any disturbance of the mind and without the appearance of any new troublesome symptoms, so that the former medicine would still be perfectly homoeopathically suitable, only then, if say, is it useful, and probably necessary to give a dose of the same medicine of a similarly small amount, but most safely in a different degree of dynamic potency.* When the remedy is thus modified, the vital force of the patient will allow itself more easily to be further affected by the same medicine, so as to effect by it everything that may be expected of this medicine and in this ailment.
To adduce an example: a freshly arisen eruption of itch belongs to those diseases which might soonest permit the repetition of the dose (sulphur), and which does permit it the more frequently, the sooner after the infection the itch is received for treatment, as it then approaches the nature of an acute disorder, and demands its remedies in more frequent doses than when it has been standing on the skin for some time. But this repetition should be permitted only when the preceding dose has largely exhausted its action (after six, eight or ten days), and the dose should be just as small as the preceding one, and be given in a different potency. Nevertheless it is in such a case often serviceable, in answer to a slight change of symptoms, to interpose between the doses of pure sulphur, a small dose of Hepar sulphuris calcareum. This also should be given in various potencies, if several doses should be needed from time to time. Often also, according to circumstances, a dose of Nux vomica (x) or one of mercury (x)** may be used between.
(* If it, has first been given in the 30th potency it will now be given in perhaps the 18th, and if a repetition should, be again found serviceable and necessary, it might afterwards be given in the 24th. and later perhaps also in the 12th and 6th, etc., if, the chronic disease should have taken on itself an acute character. A dose of medicine may also have been suddenly counteracted and annihilated by a grave error in the regimen of the patient, when perhaps a dose of the former serviceable medicine might again be given with the modification mentioned above.)
(In cases where the physician is certain as to the homoeopathic specific to be used, the first attenuated dose may also be dissolved in about four ounces of water by stirring it, and one-third may be drunk at once, and the second and third portions on the following days; but it should each time be again stirred so as to increase the potency and thus to change it. Thereby the remedy seeing to take a deeper hold on the organism and hasten the restoration in patients who are vigorous and not too sensitive.)
(** That the itch-patient during such a treatment must avoid every external application, however harmless it may appear, e.g., the washing with black soap, is not necessary to emphasize.)
—– Page – 128 —–
If I except sulphur, Hepar sulphuris and in some cases Sepia, the other antipsoric remedies can seldom be usefully given in immediately repeated doses. Indeed it is hardly ever needed in chronic
diseases, as we have a goodly supply of antipsoric remedies at our disposal, so that as soon as one well selected remedy has completed its action, and a change of symptoms, i.e., a change in the total image of the disease, appears, another antipsoric remedy homoeopathically appropriate to the altered case may be chosen to greater advantage and with a more sure prospect of hastening the cure, than if we take the risk of prescribing the former medicine which now is no longer altogether adequate. Nevertheless in very tedious and complex cases, which are mostly such as have been mismanaged by allopathic treatment, it is nearly always necessary to give again from time to time during the treatment, a dose of Sulphur or of Hepar (according to the symptoms), even to the patients who have been before dosed with large allopathic doses of Sulphur and with sulphur-baths; but then only after a previous dose of Mercury (x).
Where, as is usually the case in chronic diseases, various antipsoric remedies are necessary, the more frequent sudden change of them is a sign that the physician has selected neither the one nor the other in an appropriately homoeopathic manner, and had not properly investigated the leading symptoms of the case before prescribing a new remedy. This is a frequent fault into which the homoeopathic physician falls in urgent cases of chronic diseases, but oftener still in acute diseases from overhaste, especially when the patient is a person very dear to his heart. I cannot too urgently warn against this fault.
Then the patient naturally falls into such an irritated state that, as we say, no medicine acts, or shows its effect,* yea, so that the power of response in the patient is in danger of flaring up and expiring at the least further dose of medicine. In such a case no further benefit can be had through medicine, but there may be in use a calming mesmeric stroke made from the crown of the head (on which both the extended hands should rest for about a minute) slowly down over the body, passing over the throat, shoulders, arms, hands, knees and legs down over the feet and toes. This may be repeated if necessary.
A dose of homoeopathic medicine may also be moderated and softened by allowing the patient to smell a small pellet moistened with the selected remedy in a high potency, and placed in a vial the mouth of which is held to the nostril of the patient, who draws in only a momentary little whiff of it. By such an inhalation the powers of any potentized medicine may be communicated to the patient in any degree of strength. One or more such medicated pellets, and even those of a larger size may be in the smelling-bottle, and by allowing the patient to take longer or stronger whiffs, the dose may be increased a hundred fold as compared with the smallest first mentioned. The period of action of the power of a potentized medicine taken in by such inhalation and spread over so large a surface (as that of the nostrils and of the lungs) last as long as that of a small massive dose taken through the mouth and the fauces.
(* That a homoeopathically potentized dose of medicine should ever fail of having an effect in a treatment conducted with care, I think impossible; I have never experienced it.)
(Even persons born without the sense of smell or who have lost it through disease, may expect equally efficient help from drawing in the imperceptible vapor (proceeding from the medicine and contained in the vial) through one nostril or the other, as those do who are gifted with the sense of smell. From this it follows that the nerves possessing merely the sense of touch receive the salutary impression and communicate it unfailingly to the whole nervous system.)
—– Page – 129 —–
Such medicated pellets kept in a stoppered vial retain their medicinal power quite undiminished, even if the vial be opened a number of times in many years for the purpose of inhalation; i.e., if the vial be preserved from sunshine and heat. This method of allowing the patient to be acted upon by smelling the potentized medicine has great advantages in the manifold mishaps which often obstruct and interrupt the treatment of chronic diseases. The antidote to remove these mishaps as quickly as possible the patient may also best receive in greater or less strength through inhalation, which acts most quickly on the nerves and so also affords the most prompt assistance, by which also the continuation of the treatment of the chronic disease is least delayed. When the mishap has thus been obviated most speedily, the antipsoric medicine before taken frequently continues its interrupted action for some time. But the dose of the inhaled medicine must be so apportioned to the morbid interruption that its effect just suffices to extinguish the disadvantage arising from the mishap, without going any deeper or being able to continue its operation any further.