Medicine having the power of curing internally, should not be employed *exclusively as a topical application to the local symptoms of chronic miasmatic diseases

***LOCAL applications–what visions these words bring to mind! Mustard plasters, onion poultices, boneset and brine–in fact, anything in common usage that could be applied by the home nurse or procured by the most skilful physician. From time immemorial local applications have been the rule among the laity as domestic remedies and among physicians from ***AEsculapius down to the present day. This method of treatment was based on the teaching and general belief that if the outward manifestations were removed, the disease was cured; that the outward manifestation was the disease itself, and that the individual would be cured were the manifestations removed.

This doctrine was taught from the earliest times until Hahnemann proclaimed to the world a new doctrine, that the local manifestations were but an outward expression of the inward and spiritual force, which when disturbed expressed itself in external signs; that if these external manifestations were removed by local treatment, the disease was not cured, but driven in to some more centrally located organ, there to express itself in some graver form.

It was the custom of the older physicians to use find the local applications; then if the manifestation showed itself in the internal organs, the ever-present purge was used to drive it out. It has been said that the use of the purge was the last remnant of pagan medicine, and was based on the theory that all disease was caused by a very active evil spirit.

Hahnemann’s teaching in regard to local applications is very clear and distinct, and in practice has thoroughly proven its value. *Organon, Par. 104:

It is neither beneficial in acute local diseases of rapid growth, nor in those of long standing, to use a remedy externally as a local application to the diseased part, even if the medicines were specific and curative in that form. Acute local diseases, such as inflammations of single parts, like erysipelas, for instance, which are not produced by violent external injuries, but by dynamic or internal causes, will usually yield rapidly to internal homoeopathic remedies selected from our stock of well-tested medicines….

In a recent homoeopathic journal one of our distinguished English confreres advocated the use of the potency as a local application. This method of treatment received censorious consideration from Hahnemann, in Paragraphs 196, 197 and 198 of the *Organon.

It may seem as if the cure of a local disease could be accelerated, not only by internal administration, but also by external application of the correct homoeopathic remedy adapted to the totality of symptoms, since the effect of a medicine, applied locally to the disease itself, might possibly produce a more rapid improvement.

But this kind of treatment is entirely objectionable, not only in local affections dependent on psora, but also in local symptoms arising from syphilis and from sycosis, *because the local application of a medicine, simultaneously with its internal use, results in great disadvantages. For in diseases characterized by a main symptom in the form of a permanent local affection, the latter is generally dispelled by topical applications more rapidly than the internal disease. This often leads to the deceptive impression that we have accomplished a perfect cure. At all events the premature disappearance of this local symptom renders it very difficult, and in some cases impossible to determine whether the total disease has also been exterminated by the internal remedy.

For the same reason, a medicine having the power of curing internally, should not be employed *exclusively as a topical application to the local symptoms of chronic miasmatic diseases. For, if these are only topically suppressed, this partial effect will leave us in doubt regarding the action of the internal remedies, which are absolutely indispensable to the restoration of general health….

What, then, should be the attitude of the Hahnemannian in regard to local applications? Is it necessary that we leave the patient in all his discomfort in a chronic case like psoriasis and depend entirely upon the potentized remedy? Does the intense itching necessarily prove the deciding symptom in selecting the remedy? Just what is the meaning of local applications? If by local applications we mean something that will thwart the expression of the disease, this certainly should not be considered beneficial according to Hahnemann’s teaching; but if we base our use of local applications upon physical principles, we may consider it. For instance, in cases of psoriasis and like diseases, the scale that is thrown off by the cuticle tears the corium. This is the cause of the intense itching and is purely a mechanical disturbance. This can be removed very easily and properly by olive oil, followed by a bathing of the part, for cleansing purposes. Such conditions as appear in erysipelas, where there is great tension and dryness, may be temporarily relieved without violating Hahnemannian principles by laying on for a few minutes a soft cloth which has been dipped in a normal salt solution. Such treatments are not local applications in the sense that Hahnemann referred to in his derogation of the practice.

There is another phase of local applications to be considered, those which have to do with the thermic reactions of the body. For instance, it would be very objectionable to put cold applications on a patient whose symptomatology calls for *Rhus tox. It would be equally inconsistent and aggravating to put a local hot application on a *Pulsatilla patient, and one should guard against using a hot water bottle at the feet of *Sulphur patients. When using any adjuvants, the thermic reactions of the patient should be considered. This brings out the necessity of having a keen observation and a very thorough knowledge of the aggravations and ameliorations of our remedies, so as to avoid doing anything locally that would aggravate the general discomfort of the patient.

There is only one condition where local application of the indicated potentized remedy may be used to advantage, and that is in cases where it is impossible to administer it by mouth. This statement is based on Hahnemann’s observations that mucous surfaces and denuded surfaces are receptive to the indicated remedy, but in a more limited degree than through the alimentary canal. Paragraphs 290, 291, 292:

Besides the stomach, the tongue and mouth are the parts most susceptible of medicinal impressions; but the lining membrane of the nose possesses this susceptibility in a high degree. Also the rectum, genitals, and all sensitive organs of our body are almost equally susceptible of medicinal effects. For this reason, parts denuded of cuticle, wounded and ulcerated surfaces, will allow the effects of medicines to penetrate quite as readily as if they had been administered by the mouth, and therefore olfaction or inhalation must be still more efficacious.

Parts of the body deprived of their natural sense, e.g. in the absence of the sense of taste or smell, the tongue, palate, and nose will impart impressions made primarily on these organs, with a considerable degree of perfection to all other organs of the body.

Also the external surface of the body, covered by the cutis and cuticle, is capable of receiving the action particularly of liquid medicines; and the most sensitive parts of the surface are, at the same time, the most susceptible.

This is a subject which has not been made clear to many homoeopathic physicians, and many well-meaning practitioners have resorted to external measures; but there is no wavering in Hahnemann’s own teaching.

There are many things in common use by physicians in general whose ultimate results need to be carefully considered by the careful physician. These methods are not confined to physicians of the regular school, but are also used by many physicians who are devoting themselves to specialties. First among these methods which are objectionable from the Hahnemannian point of view and which cause trouble for a large number of patients is the indiscriminate and persistent use of astringent sprays, which are usually permeated with medicinal ingredients.This is particularly true of nasal sprays and douches, and their action is suppressive of the natural discharges of the body whenever such treatment is used, and so clogs and shuts off the natural outlets of the sinuses in the nose and face. When the natural discharges are once suppressed and shut in, we have the ideal circumstances for abscess formation, for we have heat, moisture and bacilli. No better field can be devised, not even the incubating ovens of the laboratories.

All unnatural nose and throat discharges should be met by the *simillimum for each individual case, and it is never safe to resort to, or permit the patients to use, local means to stay the flood of discharges from the nose and throat. It is much better to let them run their course without medicine than to use the slightest means to lock the natural outlets. The satisfaction and reward that the Hahnemannian homoeopath has in abiding by this rule, and staying with his patients in these aggravating conditions, and seeing them recover rapidly and painlessly in the natural order of sequence, is worth all the pains and care that are expended.

I have been in practice for nearly forty years, all of the time in New England where sinus trouble is rampant, and I have never yet had a case of sinus infection develop in my own practice. I have received many from other physicians, but have never seen one develop in a patient who has been treated with the indicated remedy.

Another field where much harm is done is in gynaecological work. Leucorrhoeal discharges are exceedingly troublesome to many patients, and astringent douches are frequently ordered by specialists in this field. Lotions and astringent douches can and do suppress the quantity of these secretions, oftentimes changing their character entirely. This treatment appeals to the patient because it speedily reduces the offensiveness of the symptom. The temptation would be to do this very thing if we did not know the fundamental law that vital energy will express itself, and in the kindliest way to the future health of the patient; when we attempt to alter by physiological means, we are bound to disturb that vital force and cause it to express itself in some other channel than that which nature chooses.

Along this same line is the promiscuous use of local applications, deodorants to suppress or change the character of perspiration. This is exceedingly objectionable, because it leaves pent up in the system that which is poisonous and injurious to the health of the individual. This condition is not often observed by the doctor unless he by chance runs across it, or is on the alert for such suppression.

In the indiscriminate use of surgery, the habit of painting the patient with iodine is objectionable from two points–that of the absorption of the drug, and from the local irritation that this drug so frequently creates. Many patients are exceedingly susceptible to drugs in such form, and it is not uncommon for involuntary provings to be made by the local use of iodine or other applications on such a patient.One patient was particularly sensitive to zinc in any form, and felt constitutional symptoms after the use of adhesive tape or talcum powders.

I want to urge strongly the use of asepsis in our obstetrical work instead of antisepsis, because at this particular period the whole female genital tract is particularly susceptible to the use of antiseptic drugs; whereas if asepsis is strictly carried out, the patient’s recovery is uneventful.