Note: This version of The Chronic Diseases by Dr. Samuel Hahnemann has been rewritten into modern, accessible English. The context, meaning, and core homeopathic principles remain strictly unchanged from the original text.

The Chronic Diseases, their Peculiar Nature and their Homeopathic Cure. by Dr Samuel Hahnemann Presented By Médi-T

Nature of Chronic Diseases.

The Homeopathic healing art, as taught in my own writings and those of my pupils, when faithfully followed, has consistently demonstrated its clear and striking superiority over any allopathic treatment. This holds true not only for diseases that suddenly afflict people (acute diseases) but also for epidemic diseases and sporadic fevers.

Venereal diseases, too, have been completely cured by Homeopathy much more reliably, with less difficulty, and without any lasting complications (sequelae). This is because, without disturbing or destroying the local symptoms, Homeopathy heals the underlying internal disease from within, using only the most appropriate specific remedy. However, the number of other chronic diseases worldwide has been, and continues to be, immeasurably greater.

Historically, treatment by allopathic physicians only served to worsen the suffering caused by these diseases. This treatment involved countless nauseating mixtures (prepared by pharmacists using potent medicines in large doses, whose individual effects were unknown to them), along with various baths, sweat-inducing (sudorific) and saliva-producing remedies, pain-killing narcotics, injections, warm compresses (fomentations), fumigations, blistering plasters, draining sores (exutories), and artificial ulcers (fontanelles). But especially prevalent were endless laxatives, leeches, cupping, and starvation diets—or whatever names were given to these medical tortures, which changed as frequently as fashion trends. Through these methods, the disease either worsened, and the vital force, despite intermittent use of so-called tonics, steadily declined. Or, if any noticeable change occurred, instead of the original suffering, a worse condition emerged: nameless, iatrogenic diseases (caused by medicine), far more severe and incurable than the initial natural illness. All the while, the physician would console the patient with words like: “I was fortunate enough to remove your previous illness; it’s a great pity that a new (?) disease has appeared, but I hope to be as successful in removing this one as I was with the last.” Thus, as the same disease manifested in different forms, and new ailments were introduced by the use of inappropriate and harmful medicines, the patient’s suffering steadily intensified until their pitiful cries were silenced forever with their dying breath. Meanwhile, relatives were placated with the comforting pretense: “Everything conceivable was done for the deceased.”

[Translator’s Note: “Exutories” were artificial ulcers or issues created to drain humors, and “fontanelles” were similar, often involving inserting foreign bodies to maintain a discharge. These were common but harsh medical practices of Hahnemann’s era. “Iatrogenic diseases” are conditions caused by medical examination or treatment.]

It is not so with Homeopathy, the great gift of God!

Even in these other types of chronic diseases, Homeopathy’s practitioners, by following the teachings presented in my previous writings and oral lectures, achieved far more than all the aforementioned treatment methods. This was especially true when they found the patient not too debilitated or harmed by allopathic treatment, which, unfortunately, was often the case when patients had the means to pay.

Employing this more natural approach, Homeopathic physicians have frequently been able to quickly resolve the chronic disease they encountered. They achieved this after thoroughly examining all perceptible symptoms and by using the most suitable Homeopathic remedies in their smallest doses, which had been proven for their pure, true effects. Crucially, this was accomplished without depleting the patient’s fluids and strength, a common practice in conventional allopathic medicine. As a result, fully healed patients could once again enjoy joyful days. These cures truly surpassed anything allopaths had ever managed to achieve—even in rare instances—by a fortunate selection from their medicine chests.

For the most part, these complaints responded to very small doses of remedies proven to produce similar morbid symptoms in a healthy body. If the disease wasn’t too deep-seated or hadn’t been severely mismanaged by allopathic treatment, it often receded for a significant period. This gave people good reason to consider themselves fortunate for even that much help, and they often expressed their gratitude. A patient treated this way could, and often did, consider themselves in quite good health, especially when fairly assessing their improved condition compared to their much more painful state before Homeopathy offered its assistance. [*]

[*] These were cures for diseases caused by a Psora not yet fully developed. My followers treated these with remedies that were not among those later identified as the primary anti-Psora remedies, simply because those remedies were not yet known. They were merely treated with medicines that Homeopathically best covered and temporarily alleviated the then-apparent moderate symptoms. This resulted in a kind of cure that returned the manifest Psora to a latent condition, thereby producing a seemingly healthy state, especially in young, vigorous individuals. This state would appear as genuine health to any observer who didn’t examine accurately, and it often lasted for many years. However, for chronic diseases caused by an already fully developed Psora, the medicines known at that time were never sufficient for a complete cure, just as these same medicines are insufficient today.

Even significant dietary mistakes, catching a cold, harsh weather conditions (rough, wet, cold, or stormy), or even a mild autumn, but especially winter and a wintry spring, could trigger issues. Furthermore, intense physical or mental exertion, a severe external injury causing a health shock, a deeply saddening event, repeated fright, profound grief, sorrow, and persistent vexation often triggered the reappearance of previously overcome ailments in a weakened body. This new state was often worsened by entirely new accompanying symptoms. While these might not be more threatening than the original ones that had been homeopathically resolved, they were frequently just as troublesome and now more stubborn. This was particularly true when the seemingly cured disease was rooted in a more fully developed Psora.

When such a relapse occurred, the Homeopathic physician would prescribe the most suitable remedy available at the time, as if treating a new disease. This approach would again be met with considerable success, temporarily improving the patient’s condition. However, in cases where only the seemingly resolved issues reappeared, the remedy that had been effective initially would prove less useful, and with repeated doses, it would help even less. Sometimes, even with the seemingly best-suited Homeopathic remedy and an entirely correct lifestyle, new disease symptoms would emerge that could only be removed inadequately and imperfectly. Indeed, these new symptoms sometimes showed no improvement at all, especially when some of the aforementioned obstacles hindered recovery.

A joyous occurrence, an improved external situation due to good fortune, a pleasant journey, a favorable season, or a dry, uniform temperature might occasionally produce a notable, temporary remission in the patient’s disease. During such a period, the Homeopath might consider the patient fairly recovered, and the patient himself, if he good-naturedly overlooked some tolerable, moderate ailments, might consider himself healthy. Yet, such a favorable pause would never last long. The recurrent complaints eventually rendered even the best-selected Homeopathic remedies of the time, given in the most appropriate doses, less effective with each repetition. They eventually served barely even as weak palliatives.

Usually, after repeated attempts to conquer the disease, which always reappeared in a somewhat altered form, residual complaints emerged that Homeopathic medicines, despite numerous trials, failed to eradicate, and often left undiminished. Thus, increasingly troublesome and varied complaints consistently followed, and, over time, became more threatening. This occurred even when the lifestyle was correct and directions were punctually observed. The chronic disease could, despite all efforts, only be slightly delayed in its progression by the Homeopathic physician and worsened year after year.

The Challenge of Chronic Diseases

This was, and remained, the gradual deterioration observed in the treatment of all severe chronic diseases not caused by venereal infections, even when these were managed precisely according to the then-known Homœopathic art. Their initial stages were promising, but the progress became less favorable, and the ultimate outcome was hopeless.

Nevertheless, this teaching was founded upon the unwavering pillar of truth and will always remain so. It has demonstrated its excellence, indeed, its near infallibility (as much as can be said of human endeavors) through undeniable facts presented to the world.

Homœopathy alone first showed how to heal clearly defined idiopathic diseases—like Sydenham’s classic scarlet fever, the more recent purpuras, whooping cough, croup, Sycosis, and autumn dysenteries—using specifically chosen Homœopathic remedies. Even acute pleurisy and typhus epidemics could now be rapidly brought to health with just a few small doses of correctly chosen Homœopathic medicine.

Why then this less favorable, indeed unfavorable, outcome in the ongoing Homœopathic treatment of non-venereal chronic diseases? What accounted for the thousands of failed attempts to achieve lasting health in other chronic conditions? Could this perhaps be due to the still limited number of Homœopathic remedies whose pure actions had been thoroughly proven? Homœopathy’s followers had, until then, comforted themselves with this idea. However, this excuse, or ‘consolation,’ never satisfied the founder of Homœopathy. This was especially true because even the valuable new medicines, proven and added year after year, failed to advance the healing of chronic (non-venereal) diseases by even a single step. In contrast, acute diseases (unless they threatened unavoidable death from the outset) were not only adequately resolved with correct application of Homœopathic remedies but, aided by the body’s ceaseless, self-preserving vital force, found a swift and complete cure.

Why is it, then, that this vital force, when effectively influenced by Homœopathic medicine, cannot achieve a true and lasting recovery in these chronic illnesses, even with Homœopathic remedies that perfectly match their current symptoms? Especially when this very same force, designed for the restoration of our organism, works so tirelessly and successfully to complete recovery even in severe acute diseases? What prevents it from doing so?

The answer to this very natural question inevitably led me to discover the true nature of these chronic diseases.

The Discovery of the Nature of Chronic Diseases

To uncover why all known Homœopathic medicines failed to provide a real cure for the aforementioned diseases, and to gain a more accurate—ideally, completely accurate—understanding of the true nature of the thousands of chronic diseases that remained uncured despite the undeniable truth of the Homœopathic Law of Cure, this extremely serious task consumed me day and night from 1816 to 1817. And indeed, the Giver of all good things allowed me, during this period, to gradually solve this profound challenge through constant thought, tireless inquiry, faithful observation, and the most precise experiments conducted for the welfare of humanity. [*]

[*] However, I did not reveal any of these uninterrupted efforts to the world or my followers. Not because the frequent ingratitude shown to me deterred me—for I pay no mind to ingratitude or persecution on my challenging life path, which, despite its difficulties, has not been entirely joyless due to the great goal I have pursued. No, I kept it unmentioned because it is improper, indeed harmful, to speak or write about things that are still undeveloped. It wasn’t until 1827 that I shared the essentials of this discovery with two of my pupils, who had rendered immense service to the art of Homœopathy, for their own benefit and that of their patients. This was to ensure that the entire discovery would not be lost to the world if, by chance, a higher calling to eternity had taken me away before the completion of this book—an event quite probable at my age of seventy-three.

It was a consistently observed fact that non-venereal chronic diseases, even after being repeatedly alleviated Homœopathically by remedies thoroughly proven at the time, always returned in a more or less varied form, with new symptoms, or reappeared annually with an increase in complaints. This observation provided me with the first clue: a Homœopathic physician dealing with such a chronic (non-venereal) case—indeed, in all cases of (non-venereal) chronic disease—must not merely fight the disease visible before him. He must not view and treat it as if it were a clearly defined illness that could be quickly and permanently eradicated and cured by ordinary Homœopathic remedies. Instead, he is always dealing with only a fragment of a deeper, underlying original disease.

The Nature of Chronic Miasmatic Diseases

The vast scope of this illness is evident in the new symptoms that emerge periodically. Therefore, a Homeopathic physician must abandon the long-held belief that these individual manifestations are distinct, self-contained diseases that can be permanently and completely cured on their own. Instead, the physician must first thoroughly investigate and uncover the full range of incidents and symptoms associated with the underlying, unknown primitive malady. Only then can they hope to identify one or more medicines whose unique symptom picture homeopathically matches and addresses the entirety of the original disease. Through this comprehensive approach, the physician can then successfully heal and eradicate the illness in its entirety, including all its individual components – that is, all the diverse fragments of the disease appearing in so many varied forms.

It became clear to me that the underlying malady we seek must also be of a miasmatic, chronic nature. This is evident because once it has progressed and developed to a certain extent, it can never be eliminated by a strong constitution, nor can it be overcome by the healthiest diet and lifestyle, nor will it simply disappear on its own. Instead, it consistently worsens year after year, transforming into different and more severe symptoms [*], persisting until the end of a person’s life, much like any other chronic, miasmatic illness. For example, consider a venereal bubo that hasn’t been internally healed by mercury, its specific remedy, but has instead developed into a full-blown venereal disease. This latter condition also never resolves on its own; even with the most proper lifestyle and a very robust physical constitution, it intensifies annually and continuously manifests new and worse symptoms, persisting, again, until the end of life.

[*] It is not uncommon for phthisis to transition into insanity; dried-up ulcers into dropsy or apoplexy; intermittent fever into asthma; abdominal affections into joint pains or paralysis; limb pains into hemorrhage, etc. It was not difficult to realize that these later manifestations must also originate from the original malady and are merely components of a much larger whole.

Discovery of the Underlying Miasm: Psora

My investigations and observations with non-venereal patients had progressed to this point when I made a crucial early discovery. I found that the primary obstacle to curing many cases – which deceptively appeared to be specific, well-defined diseases but resisted Homeopathic treatment with the then-available remedies – very often stemmed from a previous eruption of itch. Patients frequently admitted to this past itch, and the onset of all their subsequent ailments typically traced back to that period. The same pattern emerged with other chronic patients who either did not admit to such an infection, or, more commonly, had not noticed it due to inattention, or simply could not recall it. However, after careful questioning, it usually became clear that small traces of it (such as minor pustules of itch, herpes, etc.) had appeared on them from time to time, even if rarely, serving as an undeniable sign of a prior infection of this nature.

[Translator’s Note: Here, Hahnemann is referring to what he later termed Psora, one of the fundamental chronic miasms, often manifesting initially as an eruption of itch.]

Considering these observations—countless reports from physicians, [*] and often my own experience—which consistently showed that when an itch eruption was suppressed by improper treatment or disappeared from the skin through other means, it was invariably followed by the same or similar symptoms in otherwise healthy individuals. These findings, I emphasize, left no doubt in my mind about the internal adversary I needed to address in my medical approach to such cases.

[*] More recently, VON AUTENRIETH also noted this (in Tübinger Blätter für Naturwissenschaft und Arzneikunde, Vol. 2, Part 2).

Gradually, I discovered more effective treatments for this fundamental illness, which was responsible for so many complaints. This illness, which can be broadly termed Psora, is essentially an internal itch disease, whether or not it manifests with a skin eruption. It then became clear to me, through the effectiveness of these medicines in similar chronic diseases where patients couldn’t identify a similar cause, that even in cases where patients recalled no such infection, the illness was necessarily caused by Psora. They might have been infected, perhaps, even as infants, or in some other way they couldn’t remember. This was often confirmed by careful questioning of parents or older relatives.

My meticulous observations over the first eleven years, particularly regarding the help provided by anti-Psora remedies, increasingly taught me how frequently chronic diseases—not just moderate ones, but also severe and even the most severe—originate from Psora. This observation revealed that Psora is the cause of not only most of the numerous skin eruptions that Willan so meticulously differentiated and named, but also nearly all abnormal growths. These range from a common wart on a finger to the largest sarcomatous tumor, from malformed fingernails to bone swellings and spinal curvature, and many other bone softenings and deformities, whether occurring in early life or at an advanced age.

Furthermore, Psora is responsible for frequent nosebleeds (epistaxis), blood accumulation in the rectal and anal veins, bleeding from these (blind or flowing hemorrhoids), coughing up blood (hemoptysis), vomiting blood (hematemesis), blood in urine (hematuria), and both scanty and excessive menstrual discharges. It also causes night sweats lasting several years, parchment-like dry skin, chronic diarrhea lasting many years, as well as persistent constipation and difficult bowel movements, long-lasting erratic pains, convulsions recurring over several years, chronic ulcers and inflammations, sarcomatous growths and tumors, emaciation, heightened sensitivity as well as impaired senses of sight, hearing, smell, taste, and touch. It leads to both excessive and absent sexual desire; mental and emotional disorders, from severe intellectual disability (imbecility) to states of intense rapture (ecstasy), from profound sadness (melancholy) to violent madness (raging insanity); fainting spells (swoons) and dizziness (vertigo); the so-called heart diseases; abdominal complaints, and everything categorized under hysteria and hypochondria. In essence, thousands of persistent human ailments, given various names by pathology, are, with few exceptions, direct manifestations of this multifaceted Psora alone.

[Translator’s Note: While Hahnemann uses specific medical terms like ’epistaxis’, ‘hemoptysis’, etc., for clarity and readability in modern English, we’ve added common explanations in parentheses. The core miasmatic terms like Psora, Syphilis, Sycosis remain unaltered as per instructions.]

My ongoing observations, comparisons, and experiments in recent years thus taught me that the ailments and infirmities of body and soul—which, in their outward complaints, differ so radically and appear so distinct in different patients (unless they belong to the two venereal diseases, Syphilis and Sycosis)—are merely partial manifestations of the ancient miasma of leprosy and itch. In other words, they are simply descendants of one vast original disease, whose almost countless symptoms form a single whole. They should be regarded and medically treated as parts of one and the same disease, much like in a major epidemic of typhus fever. For instance, during the typhus epidemic of 1813, one patient might be severely ill with only a few symptoms of the plague, a second patient would show a few different ailments, while a third, fourth, and so on, would complain of yet other symptoms belonging to this epidemic disease. Despite these variations, they were all suffering from the same pestilential fever. The complete picture of the typhus fever prevalent at the time could only be understood by compiling the symptoms from all, or at least many, of these patients. Then, the one or two remedies, [*] identified as Homeopathic, cured the entire epidemic. They proved specifically helpful for every patient, even though one might be suffering from symptoms different from others, and almost all seemed to be afflicted with distinct diseases.

[*] During the 1813 typhus epidemic, Bryonia and Rhus toxicodendron were the specific remedies for all patients.

Similarly, but on a far grander scale, this holds true for Psora. It is the fundamental disease underlying countless chronic maladies, each of which appears distinct from the others, yet fundamentally they are not. This becomes readily apparent from the shared symptoms that emerge as these diseases progress, and also from the fact that they can all be healed by the same remedy.

The Persistent Nature of Chronic Diseases

All chronic diseases in humans, even those left untreated and not worsened by misguided medical interventions, exhibit a remarkable persistence. Once they develop and are not thoroughly cured by medical art, they continually worsen over the years and throughout a person’s entire life. Their progression cannot be slowed, nor can they be overcome or eradicated, even by the inherent strength of the most robust constitution. Consequently, these diseases never resolve on their own; instead, they intensify and worsen until death. Therefore, they must all originate from and be founded upon persistent chronic miasms, which enable their parasitic existence within the human organism to continually develop and grow. [*]

[*] See Organon of the Healing Art, fifth edition, 1834, § 100 and subsequent sections.

The Three Chronic Miasms

Based on all investigations conducted in Europe and, to our knowledge, on other continents, only three chronic miasms have been identified. Diseases caused by these miasms manifest through local symptoms, and from them, most, if not all, chronic diseases originate. These are: first, SYPHILIS, which I have also termed the venereal change disease; then SYCOSIS, or the fig-wart disease; and finally, the chronic disease underlying the itch eruption, i.e., PSORA, which I will discuss first as the most important.

Understanding PSORA

PSORA is the most ancient, most widespread, most destructive, and yet most misunderstood chronic miasmatic disease. For many thousands of years, it has afflicted and tormented humanity. In recent centuries, it has become the source of countless incredibly diverse (acute and) chronic (non-venereal) diseases, which increasingly plague the entire civilized human race across the inhabited globe.

PSORA is the oldest miasmatic chronic disease known to us. As persistent as SYPHILIS and SYCOSIS, it cannot be eradicated before the end of even the longest human life unless thoroughly cured, as not even the most robust constitution can destroy or overcome it through its own inherent strength. Beyond this, Psora, or the Itch disease, is also the oldest and most multifaceted of all chronic miasmatic diseases.

Over the many thousands of years it has afflicted humanity—for the earliest historical records do not trace its origin—PSORA has vastly expanded the scope of its pathological manifestations. This expansion can, to some degree, be attributed to its increased development over an unfathomable number of years within millions of organisms through which it has passed, making its secondary symptoms almost innumerable. If we exclude diseases caused by misguided medical practices or harmful occupational exposures to substances like mercury, lead, arsenic, etc.—which appear in conventional pathology under countless specific names as seemingly distinct and well-defined diseases (and also those originating from SYPHILIS and the even rarer ones from SYCOSIS)—then all other natural chronic diseases, whether named or unnamed, find their true origin and sole source in PSORA.

The Historical Manifestations of Psora

The earliest historical records we possess reveal Psora already well-developed. Moses, 3400 years ago, identified several distinct varieties of it. At that time, and later among the Israelites, the disease primarily manifested on the external parts of the body. This pattern held true as the malady spread through ancient Greece, then Arabia, and finally Europe during the Middle Ages. The various names given by different nations to the more or less severe forms of leprosy (the external symptom of Psora), which often disfigured the body, are not relevant to our discussion. This is because the fundamental nature of this miasmatic itching eruption remained essentially the same.

Moses’s writings in Leviticus (chapter 13, and chapter 21, verse 20, where he discusses bodily defects disqualifying a priest from offering sacrifice) refer to a malignant itch using the word garab. The Alexandrian translators (in the Septuagint) rendered this as psora agria, while the Vulgate used scabies jugis. The Talmudic interpreter, Jonathan, described it as a dry itch spread over the body. Moses also used the term yalephed for conditions like lichen, tetter, and herpes (see M. Rosenmueller, Scholia in Levit., p. II., edit. sec., p. 124). Commentators in the English Bible-work, including Calmet, concur, stating: “Leprosy is similar to an inveterate itch with violent itching.” Ancient texts also describe the characteristic, intensely pleasurable itching associated with itch, then as now, which is followed by a painful burning sensation after scratching. Plato, for instance, called itch glykypikron (sweet-bitter), while Cicero noted the dulcedo (sweetness or pleasure) of scabies.

The Western Psora, which had ravaged Europe for several centuries during the Middle Ages as malignant erysipelas (known as St. Anthony’s Fire), transformed back into leprosy when the crusaders returned in the thirteenth century, bringing the disease with them. Although it spread even more widely across Europe than before (in 1226, France alone had 2,000 leper houses), this Psora, now manifesting as a dreadful eruption, found some external relief through improved hygiene. These advancements, including (cotton? linen?) shirts previously unknown in Europe and the more frequent use of warm baths, were also introduced by the crusaders from the Orient. Thanks to these measures, along with a more refined diet and improved living standards brought about by increased cultural development, the external horrors of Psora gradually diminished over several centuries. By the end of the fifteenth century, it appeared only as the common itch, precisely when the other miasmatic chronic disease, Syphilis, began (in 1493) to emerge with its dreadful manifestations.

In more developed regions, this eruption was externally reduced to a common itch and could be much more easily cleared from the skin using various methods. Consequently, with the introduction of external medicinal treatments—especially among the middle and upper classes—such as baths, washes, and ointments containing sulfur and lead, as well as preparations of copper, zinc, and mercury, the external manifestations of Psora on the skin were, and still are, often suppressed so quickly that in most cases, whether in children or adults, the history of itch infection might remain completely unknown.

However, the condition of humanity did not improve; in many ways, it became significantly worse. In ancient times, although the Psora eruption, manifesting as leprosy, was extremely distressing to sufferers due to the sharp, shooting pains and intense itching around the tumors and scabs, the rest of their body generally maintained a reasonable level of health. This was because the stubbornly persistent skin eruption acted as a substitute for the internal Psora. More importantly, the horrifying and repulsive appearance of lepers made such a terrible impression on healthy individuals that they feared even approaching them. Consequently, the isolation of most of these patients and their segregation in leper hospitals kept them separate from general society, thus limiting infection from them, making it comparatively rare.

During the fourteenth and fifteenth centuries, as Psora took on a much milder form, appearing as itch, the few pustules that emerged after infection were inconspicuous and easily hidden. However, these pustules were constantly scratched due to their unbearable itching, spreading the fluid and, consequently, the Psora miasma. The more these lesions were concealed, the more certainly and easily the miasma was communicated to many other individuals. This is because objects contaminated by the Psora fluid infected people who unknowingly touched them, thus contaminating far more individuals than lepers, who were carefully avoided due to their horrifying appearance.

Psora has thus become the most infectious and widespread of all chronic miasmas. This miasm is typically transmitted to others even before the affected individual seeks or receives any external suppressive treatment for their itchy eruption (such as lead-water or mercury precipitate ointment). Often, the person doesn’t admit to having an itch eruption, or may not even be aware of it themselves. Furthermore, physicians or surgeons frequently fail to recognize the true nature of the eruption that has been suppressed by lotions like lead-water.

It’s easy to understand how the poorer and lower classes, who often allow the itch to spread extensively on their skin until they become repulsive to those around them and are forced to seek treatment, must have infected many others in the interim.

Humanity is, therefore, in a worse state due to the transformation of Psora’s external manifestation – from leprosy down to the simple itch eruption. This is not only because the itch is less visible, more concealed, and thus more frequently infectious, but also, crucially, because Psora, though externally softened into a mere itch and consequently more widely disseminated, still retains its original dreadful nature unchanged. Now, being more easily suppressed, the disease progresses even more imperceptibly internally. Over the last three centuries, following the suppression [Footnote 1] of its primary symptom (the external skin eruption), Psora has taken on the unfortunate role of causing countless secondary symptoms. In other words, it gives rise to a multitude of chronic diseases whose origin physicians neither suspect nor understand, and which they are therefore no more able to cure than they could cure the original disease when it presented with its skin eruption. Daily experience, however, shows that these chronic diseases are inevitably worsened by the numerous ineffective remedies applied.

Psora has lost this beneficial characteristic due to the increasingly milder nature of its primary symptom, which has transformed from leprosy to itch over the last three centuries. The itch eruption by no means remains as persistently on the skin as the chancre or the fig-wart. Even if the itch eruption has not been suppressed from the skin (as is almost always the case) by the misguided practices of physicians and quacks using drying washes, sulfur ointments, drastic purgatives, or cupping, it frequently disappears, as we say, ‘of itself’ – meaning through unnoticed causes. It often vanishes due to some unfortunate physical or psychological event, a violent fright, continuous annoyances, profound grief, catching a severe cold, or exposure to cold temperatures (see below, observation 67); through cold, lukewarm, or 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 diarrhea; or sometimes perhaps due to a peculiar lack of activity in the skin. The consequences in such cases are just as detrimental as if the eruption had been externally suppressed by a physician’s irrational practice. The secondary ailments of internal Psora and any of the countless chronic diseases stemming from this origin will then manifest sooner or later.

However, no one should assume that Psora, mitigated in its local symptom – its skin eruption – differs significantly from ancient leprosy. Even leprosy, when not deeply entrenched, could in ancient times often be cleared from the skin by cold baths, repeated river immersions, or warm mineral baths (see below, No. 35). But even then, the resulting harmful effects were as little heeded as modern physicians disregard the acute diseases and insidious maladies that inevitably develop sooner or later from the internal Psora when a present-day itch eruption has disappeared spontaneously or been forcibly suppressed.

Such an overwhelming surge of countless nervous disorders, painful conditions, spasms, ulcers (cancers), abnormal growths, dyscrasias, paralyses, consumptions, and impairments of soul, mind, and body were never observed in ancient times when Psora largely manifested as its dreadful skin symptom, leprosy. Only in the last few centuries has humanity been inundated with these infirmities, due to the causes just mentioned. [Footnote 2]

[Footnote 1] The external itch eruption can be suppressed not only by the misguided practices of physicians and quacks, but unfortunately, it also quite often disappears from the skin spontaneously (see below, e.g., in the observations of older physicians, Nos. 9, 17, 26, 36, 50, 58, 61, 64, 65). Syphilis and Sycosis both hold an advantage over itch disease because their primary external manifestations – the chancre (or bubo) in Syphilis and the fig-wart in Sycosis – never disappear externally until they are either harmfully destroyed by external suppressive remedies or rationally removed through the simultaneous internal cure of the entire disease. Therefore, the internal venereal disease (Syphilis) cannot manifest as long as the chancre is not artificially destroyed by external applications, nor can the secondary ailments of Sycosis appear as long as the fig-wart has not been destroyed by misguided treatment. These local symptoms act as substitutes for the internal disease, persisting even until the end of a person’s life and preventing the internal disease from erupting. Consequently, it is just as easy to heal them completely and thoroughly with their specific internal medicines, which only need to be continued until these local symptoms (chancre and fig-wart) – which are inherently unchangeable except through artificial external application – are fully resolved. Only then can we be certain that we have thoroughly cured the internal disease, namely Syphilis and Sycosis.

[Footnote 2] I have no doubt that the widespread consumption of warm coffee and Chinese tea over the last two centuries, which has significantly increased both muscular irritability and excessive nerve excitability, has further amplified the predisposition of this era to a multitude of chronic diseases, thereby assisting Psora. I have, perhaps too prominently, highlighted coffee’s role in human physical and mental suffering in my small work, ‘The Effects of Coffee’ (Die Wirkungen des Kaffees. Leipzig, 1803). This, perhaps excessive, emphasis was due to the fact that I had not yet discovered Psora as the primary source of chronic diseases. Only in conjunction with the excessive use of coffee and tea – both of which offer temporary relief for several Psora symptoms – could Psora spread such innumerable and obstinate chronic sufferings among humanity; for Psora alone could not have produced this effect.

PSORA thus became the most widespread origin of chronic diseases.

Psora, which is now so easily and carelessly deprived of its beneficial skin symptom—the itch eruption that acts as a substitute for the internal disease—has, over the last three hundred years, been generating an increasing number of secondary symptoms. In fact, so many chronic illnesses now stem from Psora as their sole source that it accounts for at least seven-eighths of all such maladies. The remaining eighth originates from Syphilis and Sycosis, or from a combination of two of these three miasmatic chronic diseases, or (rarely) from a combination of all three. Even Syphilis, which due to its easy curability responds to the smallest dose of the best preparation of Mercury, and Sycosis, which is relatively easy to cure with a few alternating doses of Thuja and nitric acid, only become persistent, difficult-to-cure illnesses when they are complicated with Psora. Therefore, among all diseases, PSORA is the most misunderstood and, consequently, has been medically treated in the most detrimental and harmful way.

It is truly astonishing how profoundly conventional physicians have erred against the well-being of humanity. Almost without exception, medical educators and leading contemporary physicians and writers have established and taught as an unquestionable truth that: “Every itch eruption is merely a local skin condition, with the rest of the body playing no part whatsoever. Therefore, it can and must be removed from the skin at any time, without hesitation, using local applications like sulfur ointment, the even more potent Jasser’s ointment, sulfur fumigations, lead and zinc solutions, or most rapidly, mercury precipitates. Once the eruption is gone from the skin, everything is considered fine; the person is restored, and the entire disease is believed to be eradicated. However, they concede that if the eruption is neglected and allowed to spread, then this ‘malignant matter’ might eventually find a way to penetrate through the absorbent vessels into the body’s humors, thereby corrupting the blood, the humors, and overall health. In such cases, a person might indeed suffer from illnesses caused by these harmful humors, though these could supposedly be quickly expelled from the body by purgatives and cleansing agents. But, they assert, by promptly removing the eruption from the skin, all subsequent complications are prevented, and the internal body remains completely healthy.”

These terrible falsehoods have not only been taught and continue to be taught, but they are also actively put into practice. The result is that today, patients in all the most renowned hospitals—even in seemingly enlightened countries and cities—as well as private itch patients from all social classes, and patients in all penitentiaries, orphan asylums, and other civil and military hospitals where such eruptions are found—in short, countless patients without exception—are treated not just by obscure physicians, but by all, even the most celebrated ones, using the aforementioned external remedies. [] They might also simultaneously administer large doses of flowers of sulfur and strong purgatives (to “cleanse the body,” as they claim). These physicians believe that the faster these eruptions are driven from the skin, the better. Then, with brazen assurance, they discharge patients as “cured,” declaring that “everything is now all right,” [] completely disregarding or refusing to acknowledge the ailments that are sure to follow sooner or later; namely, the Psora which manifests internally in a thousand different diseases. [] If these deceived, unfortunate individuals later return with the unavoidable illnesses resulting from such treatment—for example, with swellings, persistent pains in various body parts, hypochondriac or hysterical issues, gout, consumption, tubercular phthisis, continuous or spasmodic asthma, blindness, deafness, paralysis, bone decay (caries), ulcers (cancer), spasms, hemorrhages, mental and emotional disorders, etc.—the physicians imagine they are facing something entirely new. They then treat these new conditions repeatedly according to their old therapeutic routines in a useless and harmful manner, directing their medicines against phantom diseases, meaning against causes they invent for the appearing ailments. This continues until the patient, after many years of suffering that is constantly aggravated, is finally released from their care by death, the ultimate end of all earthly maladies. [****]

[*] Then, as these gentlemen, in their twisted minds where they have arbitrarily dismissed the true nature of this most important disease without consulting nature, assure us, the matter of the itch has not yet had time to penetrate inwardly and be absorbed by the vessels to the detriment of the entire fluid mass (humors). But how then, O conscientious men! if even the first small pustule of itch, with its unbearable, intensely pleasurable itching that irresistibly compels a person to scratch, and the subsequent burning pain, is in every case and every time proof of a widespread itch disease that has already developed deep within the entire organism, as we shall see below? How then, if, in accordance with this fact, any external suppression of the itch eruption can not only do nothing to alleviate the internal general disease, but rather, as thousands of facts prove, compel it to develop and erupt quickly into innumerable, diverse, acute sufferings, or gradually into chronic sufferings, which render 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 its inherent law of nature (its instinct showing more wisdom than the intelligence of its destroyers), after some weeks, drives the eruption—which seemed destroyed by itch ointments and purgatives—back to the skin. The patient returns to the hospital, and the harmful destruction of the eruption by means of ointments and lotions of lead and zinc solutions is renewed. I have seen this eruption thus destroyed in an irrational and cruel manner three times in succession within a few months in military hospitals, 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 truly impossible.

[***] I wrote this six years ago, but even to this day, physicians of the old school continue to act and teach with the same criminal negligence. In this most important medical matter, they have not become the least bit wiser or more humane.

[****] By accident (for they cannot give any but a feigned reason for their action), they discovered a temporary refuge that often alleviates their patients’ sufferings when their prescriptions fail against unknown diseases at home. That is, they send the patient to some sulfur bath or other, where patients often get rid of a small part of their Psora, and thus, at the first use of the baths, are temporarily relieved of their chronic disease. However, they later relapse into the same or a similar ailment, and repeated baths then offer little or no benefit, because the cure of a developed Psora requires a far more adequate treatment than the impulsive use of such baths.

Older physicians were more diligent and observed these matters with less bias. They clearly saw and became convinced that countless ailments and the most severe chronic diseases often developed after the suppression of an itch-eruption from the skin. This experience led them to believe that an internal disease was present. Consequently, in every case of itch, they tried to eradicate this internal illness using a variety of internal remedies, employing the best treatments available in their therapeutics.

However, this was ultimately a futile effort, because the true healing method—one that only Homœopathy could discover—was unknown to them. Nevertheless, their sincere efforts were commendable, as they were based on the understanding that a significant internal disease accompanied the itch eruption, and that this internal disease needed to be removed. This understanding prevented them from relying solely on the local suppression of the itch from the skin, a practice common among modern physicians who believe they can quickly eliminate it—as if it were merely an external skin disease—without considering the significant harm such a course entails. In contrast, older physicians, through their writings and thousands of examples, explicitly warned us about these potential harms.

The observations of these honest individuals are too striking to be dismissed contemptuously or overlooked by conscientious practitioners.

Here, I will present some of the many observations passed down to us. I could easily add an equal number of my own, but these are already more than enough to demonstrate the ferocity with which internal Psora manifests when its external local symptom—which temporarily alleviates the internal illness—is hastily suppressed. These observations also highlight that it is a matter of conscience for any physician who cares for humanity to focus all efforts on curing the internal malady first. By doing so, the skin eruption will simultaneously resolve and disappear, and all the countless lifelong chronic sufferings stemming from Psora will either be prevented or, if they are already making the patient’s life miserable, be cured.

The diseases—some acute, but primarily chronic—that arise from such a one-sided suppression of the main skin symptom (eruption and itching), which acts as a substitute and alleviates the internal Psora (a suppression mistakenly called “driving the itch into the body”), are countless. They are as diverse as the individual bodily constitutions and the external environmental factors that influence them.

An experienced and honest physician, LUDWIG CHRISTIAN JUNCKER, provides a brief overview of the many misfortunes resulting from this in his Dissertatio de Damno ex Scabie Repulsa (Treatise on the Harm from Repelled Scabies), published in Halle in 1750, pages 15-18. He observed that in young people with a sanguine temperament, suppressing itch led to phthisis (tuberculosis). In sanguine individuals generally, it resulted in piles (hemorrhoids), hemorrhoidal colic, and renal gravel (kidney stones). For those with a sanguino-choleric temperament, it caused swollen inguinal glands, stiff joints, and malignant ulcers (known in German as Todenbrüche). Obese individuals developed suffocating catarrh and mucous consumption. Other consequences included inflammatory fever, acute pleurisy, and lung inflammation. He also noted that autopsies revealed lungs that were hardened (indurated) and filled with pus-containing cysts, along with other indurations, bone swellings, and ulcers following eruption suppression. Phlegmatic individuals primarily suffered from dropsy (edema) after such suppressions; menstruation was delayed, and if the itch was suppressed during their period, it transformed into monthly hemoptysis (coughing up blood). Melancholic individuals sometimes became insane due from such repression; if pregnant, the fetus usually died. Sometimes, itch suppression caused sterility [*]; in nursing mothers, milk production often ceased, and menstruation disappeared prematurely. In older women, the uterus became ulcerated, accompanied by deep, burning pains and wasting away (uterine cancer).

[*] A pregnant Jewish woman had itch on her hands and suppressed it in her eighth month of pregnancy to avoid it being visible during delivery. Three days later, she gave birth, but the lochial discharge (postpartum bleeding) did not appear, and she developed a high fever. For the next seven years, she remained sterile and suffered from leucorrhea. Later, she became impoverished and had to walk long distances barefoot. Following this, the itch reappeared, and she consequently lost her leucorrhea and other ‘hysteric affections.’ She became pregnant again and had a safe delivery. (Juncker, ibid.)

His experiences were frequently corroborated by the observations [*] of other practitioners, for example, concerning:

[*] When I wrote the first edition of The Chronic Diseases, I was not yet familiar with Autenrieth’s Versuche fuer die prakt. Heilkunde aus den Klinischen Anstalten von Tübingen (Experiments for Practical Medicine from the Clinical Institutions of Tübingen), published in 1808. However, upon examining his work, I found that his statements about diseases following the suppression of itch through local applications merely confirmed what I had already discovered from hundreds of other writers. He, too, observed that externally suppressing itch led to foot ulcers, pulmonary consumption (tuberculosis), hysterical chlorosis with various menstrual irregularities, white swelling of the knee, joint dropsy (effusion), epilepsy, amaurosis (blindness) with obscured cornea, glaucoma with complete amaurosis, mental derangement, paralysis, apoplexy (stroke), and neck curvature. He mistakenly attributed these solely to the ointments. However, his own slow, local suppression of the eruption using potassium sulfide and soft soap—which he futilely calls ‘healing’ it—is no better. It’s as if his treatment were anything other than a local suppression of the eruption from the skin! He knows as little about a true cure as 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 utterly misguided to attempt to cure an internal itch-disease—which cannot be cured by any local application—through anything other than internal means, which alone can cure the disease thoroughly and with certainty.

Asthma

Lentilius Miscellanea medica practica (Practical Medical Miscellany), Tom. I., p. 176. Fr. Hoffmann Abhandlung von den Kinderkrankheiten (Treatise on Children’s Diseases), Frft., 1741, p. 104. Detharding in Appendix ad Ephemerides Naturae Curiosorum Decuria III, annus 5 et 6 et in observationibus parallelis ad observationem 58 (Appendix to the Ephemerides of the Curious in Nature, Decuria III, year 5 and 6, and in parallel observations to observation 58). Binninger, Observationes Centuria V, observatio 88 (Observations, Century V, observation 88). Morgagni, De sedibus et causis morborum per anatomen indagatis Epistola XIV, 35 (On the Seats and Causes of Diseases Investigated by Anatomy, Letter XIV, 35). Acta Naturae Curiosorum Tomus V, observatio 47 (Proceedings of the Curious in Nature, Volume V, observation 47). J. Juncker, Conspectus therapeuticae specialis, tabula 31 (Overview of Special Therapeutics, table 31). F. H. L. Muzell, Wahrnehmungen Sammlung II, Casus 8 (Collection of Observations II, Case 8). [1] J. Fr. Gmelin in Gesner’s Sammlung von Beobachtungen V, Seite 21 (Collection of Observations V, page 21). [2] Hundertmark.-Zieger Dissertatio de scabie artificiali, Lipsiae 1758, p. 32 (Dissertation on Artificial Scabies, Leipzig 1758, p. 32). [3] Beireis-Stammen. Dissertatio de causis cur imprimis plebs scabie laboret. Helmstadii, 1792, p. 26 (Dissertation on the Causes why the Common People Especially Suffer from Scabies, Helmstedt, 1792, p. 26). [4] Pelargus (Storch) Observationes clinicae, Jahrgang 1722, p. 435 et 438 (Clinical Observations, Year 1722, p. 435 and 438). [5] Breslauer Sammlung vom Jahre 1727, p. 293 (Breslau Collection from the Year 1727, p. 293). [6] Riedlin, the father, Observationes Centuria II, observatio 90 (Observations, Century II, observation 90). Augsburg, 1691. [7]

Suffocating Catarrh

Ehrenfr. Hagendorn, Historiae medico-physicae Centuria I, historia 8, 9 (Medical-Physical Histories, Century I, history 8, 9). [8] Pelargus, Observationes clinicae, Jahrgang 1723, p. 15 (Clinical Observations, Year 1723, p. 15). [9]

Suffocation from Asthma

Joh. Phil. Brendel, Consilia medica, Frankfurt, 1615, Cons. 73. Ephemerides Naturae Curiosorum, Ann. II, Obs. 313. Wilh. Fabr. V. Hilden, Observationum Centuria III, Obs. 39 [10]. Ph. R. Vicat, Observationes Practicae, Obs. 35, Vitoduri, 1780 [11]. J. J. Waldschmid, Opera, p. 244 [12].

Asthma with Generalized Swelling

Waldschmid, as above. Hoechstetter, Observationum Decas III, Obs. 7, Frankfurt and Leipzig, 1674, p. 248. Pelargus, Observationes Clinicae, Jahrgang 1723, p. 504 [13]. Riedlin, the elder, Observationum Centuria II, Obs. 91 [14].

Asthma with Chest Dropsy

Storch in Acta Naturae Curiosorum, Vol. V, Obs. 147. Morgagni, De Sedibus et Causis Morborum, XVI, Art. 34 [15]. Richard, Recueil d’observations de Médecine, Vol. III, p. 308, Paris, 1772. Hagendorn, as above, Cent. II, Hist. 15 [16].

Pleurisy and Chest Inflammation

Pelargus, as above, p. 10 [17]. Hagendorn, as above, Cent. III, Hist. 58. Giseke, Hamburgische Abhandlungen, p. 310. Richard, as above. Pelargus, as above, Jahrgang 1721, p. 23 and 114 [18], and Jahrgang 1723, p. 29 [19], also in Jahrgang 1722, p. 459 [20]. Sennert, Praxis Medica, Book II, Part III, Chapter 6, p. 380. Jerzembsky, Dissertatio: Scabies Salubris in Hydrope, Halle, 1777 [21]. Karl Wenzel, Die Nachkrankheiten von zurückgetretener Krätze (The After-diseases of Suppressed Scabies), Bamberg, 1826, p. 49 [22].

Pleurisy and Cough (Pelargus, Jahrg., 1722, p. 79) [23]

Severe Cough (Richard; Juncker, Conspectus Medicinae Theoreticae et Practicae, Table 76; Hundertmark, p. 23) [23*]

Hemoptysis (Phil. Georg. Schroeder, Opuscula II., p. 322; Richard; Binninger, Observationes Centuria V, observation 88)

Hemoptysis and Consumption (Chn. Max Spener, Dissertation on a patient suffering from malignant fever complicated by phthisis, Giess, 1699 [24]; Baglio, Works, p. 215; Sicelius, Practice of Cases, Exercise III, Case I, Frft et Lips, 1743 [25]; Morgagni, XXI., Article 32 [26]; Unzers Arzt C C C., p. 508 [27]; Karl Wenzel, p. 32)

[Translator’s Note: In this text, the term “itch” is consistently replaced with “Psora” to reflect Hahnemann’s understanding of the underlying chronic miasm, which he believed manifested as various skin eruptions and other chronic diseases.]

Pathological Consequences of Suppressed Eruptions

• Pus Accumulation in the Chest. F. A. Waitz, Medicinisch-Chirurgische Aufsätze, Th. I., p. 114, 115. [28] Preval, in the Journal de Médecine, LXI., p. 491.
• Intestinal Pus Cysts, Krause. Schubert, Diss. de scabie humana. Lipsiae, 1779, p. 23. [29]
• Extensive Degeneration of a Large Portion of the Intestines. J. H. Schulze, in Acta Naturae Curiosorum, Tom. I, obs. 231. [30]
• Brain Degeneration. Dimenbrock, Observationes et Curationes Medicae, obs. 60. Bonet, Sepulchretum Anatomicum, Sect. IV, obs. I, §1 [31] and §2. [32] J. H. Schulze, as above.
• Hydrocephalus, Acta Helvetica, V., p. 190.
• Stomach Ulcers. L. Chn. Juncker, Diss. de scabie repulsa, Halle, 1750, p. 16. [33]
• Gangrene of the Stomach and Duodenum. Hundertmark, as above, p. 29. [34]
• Generalized Edema. [35]
• Chest Dropsy. Hessler in Karl Wenzel, as above, p. 100 and 102.

Observed Conditions and Their Sources:

• Abdominal Dropsy: Richard (as cited previously) and other observers.
• Scrotal Swelling (in boys): F. Hoffmann, Medicinae rationalis systematicae, Vol. III, p. 175.
• Generalized Red Swelling of the Body: Lentilius, Miscellanea medico-practica, Part I, p. 176.
• Jaundice: Baldinger, Diseases of an Army, p. 226; J. R. Camerarius, Memorable Centuries, Vol. X, §65.
• Swelling of the Parotid Glands: Barette, in the Journal of Medicine, Vol. XVIII, p. 169.
• Swelling of the Cervical Glands: Pelargus (as cited previously), Year 1723, p. 593. [36] Unzer, Physician, Part VI, St. 301. [37]
• Blurred Vision and Presbyopia: F. Hoffmann, Medical Consultations, Vol. I, Case 50. [38]
• Inflammation of the Eyes (Ophthalmia): G. W. Wedel; Snetter, Dissertation on Ophthalmia, Jena, 1710; Hallmann, in Royal Swedish Academy of Sciences Proceedings for Year X, p. 210. [39] G. C. Schiller, On Humid Scabies, p. 42, Erfurt, 1747.

The author of Epidemics, Book 5, No. 4, identified as Hippocrates, first documented a tragic outcome in such a case: an Athenian suffered from a violently itching eruption that covered his entire body, particularly his genital organs. He managed to suppress this eruption by using warm baths on the island of Melos, but subsequently died from the resulting dropsy.

Clinical Observations and References

• Cataract: Christian Gottlieb Ludwig, Adversaria Medica, Vol. II, p. 157. [40]
• Amaurosis: Northof, Dissertation on Scabies, Göttingen, 1792, p. 10. [41] Christian G. Ludwig, as cited above. [42] Sennert, Praxis, Book III, Section 2, Chapter 44. Trecourt, Chirurgical Observations, p. 173, Leipzig, 1777. Fabricius ab Hilden, Centuria II, Observation 39. [43]
• Deafness: Thore in Capelle, Journal of Health, Vol. I. Daniel, System of Diseases, Vol. II, p. 228. Ludwig, as cited above.
• Inflammation of the Bowels: Hundertmark, Dissertation on Artificial Scabies, Lipsiae (Leipzig), 1758, p. 29.
• Piles (Hemorrhoids): Acta Helvetica, Vol. V, p. 192. [44] Daniel, System of Diseases, Vol. II, p. 245. [45]
• Abdominal Complaints: Friedrich Hoffmann, Medicina Rationalis Systematica, Vol. III, p. 177. [46]
• Diabetes (Mellitus): Commentarii Lipsienses, Vol. XIV, p. 365. Ephemerides Naturae Curiosorum, Decuria II, Year 10, p. 162. C. Weber, Observationes, Fasciculus I, p. 26.
• Suppression of Urine: Sennert, Praxis, Book 3, p. 8. Morgagni, as cited above, XLI, Article 2. [47]
• Erysipelas: Unzer, The Physician, Part V, p. 301. [48]

Explanatory Notes

Conditions Linked to Suppressed Eruptions

• Corrosive Discharges. Fr. Hoffman, Consult. Tom. II., Cas. 125.
• Ulcers. Unzer Arzt, Th. V., St. 301. [49] Pelargus, as above, Jahrg., 1723, p. 673. [50] Breslauer Samm., 1727, p. 107. [51] Muzell, Wahrnehm. II., Cas. 6. [52] Riedlin, the son, Cent. obs. 38. [53] Alberti-Gorn, Diss. de scabi., p. 24. Halle, 1718.
• Caries (Bone decay). Richard, as above.
• Swelling of the Knee Bones. Valsalva in Morgagni, de sede et caus. morb. I. art. 13.
• Bone Pain. Hamburger Magaz., XVIII., p. 3, 253.
• Rachitis (Rickets) and Marasmus in Children. Fr. Hoffman. Kinderkrankh. Leipiz., 1741, p. 132.
• Fever. B. V. Faventinus, Medicina empir., p. 260. Ramazzini, Constit. epid, urbis. II. No. 32, 1691. [54] J. C. Carl in Act. Nat. Cur. VI., obs. 16. [55]
• Fever. Reil, Memorab. Fasc. III., p. 169. [56] Pelargus, as above; Jahrg., 1721, p. 276. [57] and ibid. Jahrg., 1723. [58] Amatus, Lusit. Cent. II., Cor. 33. Schiller Diss. de scabie humida, Erford, 1747, p. 44. [59] J. J. Fick, Exercitatio med. de scabie retropulsa. Halle, 1710, §2. [60] Pelargus, as above, Jahrg,. 1722, p.122. [61] Also Jahrg., 1723, p.10, p.14. [62] and p. 291. C. G. Ludwig, Advers. med. II., pp. 157-160. [63] Morgagni, as ab. X., art. 9; [64] XXI., art. 31; [65] XXXVIII., art. 22; [66] LV., art. 3. [67]

Case Studies and Observations

Fever

Various authors have documented cases related to fever. These include:

• Lanzonus, in Ephemerides Naturae Curiosorum, Decade III, years 9 and 10, observations 16 and 113.
• Hoechstetter, Observationes Medicae, Decade VIII, Case 8. [See Case 68 below]
• Triller.
• Wehle, Dissertation: Sometimes No Medicine is the Best Medicine, Wittenberg, 1754. [See Case 69 below]
• Fick, as mentioned above, Section 1. [See Case 70 below]
• Waldschmidt, Opera, page 241.
• Gerbizius, in Ephemerides Naturae Curiosorum, Decade III, year 2, observation 167.
• Amatus Lusitanus, Centuriae, Century II, Cure 33. [See Case 71 below]
• Fr. Hoffmann, Medicina Rationalis Systematica, Volume III, page 175. [See Case 72 below]

Case Studies on Suppressed Itch and Subsequent Fevers:

[68] A severe fever, accompanied by opisthotonus (a severe spasm where the back arches and the head and heels bend backward), developed after the suppression of an itch eruption.

[69] A young merchant, after suppressing an itch eruption with an ointment, suddenly experienced such severe hoarseness that he couldn’t speak loudly. This was followed by dry asthma, loss of appetite, a persistent cough (especially troublesome at night, robbing him of sleep), violent, foul-smelling night sweats, and ultimately, despite all medical interventions, death.

[70] A 60-year-old burgomaster suffered terribly from an itch eruption, particularly at night. After many unsuccessful treatments, he was finally advised by a beggar to use a supposedly infallible remedy made of oleum laurinum (laurel oil), flowers of sulphur, and lard. After several applications, the eruption indeed disappeared. However, soon after, he was seized by a violent chill, followed by intense body heat, extreme thirst, gasping asthma, sleeplessness, severe full-body trembling, and profound weakness. He died on the fourth day.

[71] From the same cause (suppression of itch), a fever combined with insanity occurred, leading to rapid death.

[72] Acute fevers, often accompanied by a significant loss of strength, frequently follow the suppression of an itch eruption. In one such instance, the fever lasted seven days until the itch eruption reappeared, at which point the fever subsided.

Tertian Intermittent Fever

Pelargus, as above, Jahrgang 1722, p. 103, compare with p. 79. [73] Juncker, as above, table 79; Ephemerides Naturae Curiosorum (Annals of the Curious about Nature), Decade I, Year 4. Welsch, Observation 15. Sauvages, Species II. De Hautesierk, Observations, Volume II, p. 300; Commentaries of Leipzig XIX, p. 297.

Quartan Fever

Thom. Bartholinus, Chapter 4, History 35. Sennert, Paralipomena (Supplementary Notes), p. 116. Fr. Hoffman, System of Rational Medicine III, p. 175. [74]

Vertigo and a Total Sinking of Strength

Gabelchofer, Medical Observations, Century II, Observation 42.

Vertigo Resembling Epilepsy

Fr. Hoffmann, Medical Consultations I, Case 12. [75]

In the same article, Morgagni mentions the case of a man who, having scabs from an itchy eruption on his arms and other parts of his body, suppressed nearly the entire eruption using a sulfur-treated shirt. Immediately, he developed drawing pains throughout his body, accompanied by fever, so severe that he could neither rest at night nor move during the day. His tongue and throat were similarly affected. With great difficulty, the eruption was brought back to the skin, and his health was restored.

Case Studies on Suppressed Skin Conditions and Their Consequences

Here are some historical references illustrating the adverse effects of suppressing skin conditions:

• Epilepsy-Like Vertigo: F. Hoffmann, as above, p. 30.
• Convulsions: Juncker, as above, table 53. Hoechstetter, Ephemerides Naturae Curiosorum, Decade 8, Case 3. Ephemerides Naturae Curiosorum, Decade 2, Year, Observation 35, and Year 5, Observation 224. D. W. Triller. Welle, Dissertation: Sometimes No Medicine Is the Best Medicine, Wittenberg, 1754, §§13, 14.
• Sicelius, Decade of Cases I, Case 5.
• Pelargus, as above, Year 1723, p. 545.

Epileptic Convulsions and Epilepsy

J. C. Carl in Act. Nat. Cur. VI., obs. 16. [80] E. Hagendorn, as above, hist. 9. [81] Fr. Hoffmann, Consult. med. I., Cas. 31. [82]; ibid. med. rat. syst. T. IV., p. III., Cap. I., and in Kinderkrankheiten, p. 108. Sauvages, Nosol. spec. II. de Hautesierk, obs. T. II., p. 300. Sennert, prax. III., Cap. 44. Eph. Nat. Cur. Dec. III., ann. 2, obs. 29. Gruling, obs. Med. Cent. III., obs. 73. Th. Bartolin, Cent. III., hist. 20. Fabr. de Hilden, Cent. III., obs. 10. [83] Riedlin, lin. med. ann., 1696, Maj. obs. I. [84] Lentilius, Miscell. med. pr., P. I., p.32. G. W. Wedel, Diss. de ægro epileptico, jen., 1673. [85] Herrm. Grube, de arcanis medicorum non arcanis, Hafn., 1673, p.165. [86] Tulpius, obs. lib. I., Cap. 8. [87] Th. Thompson, Medic. Rathpflege, Leipzig, 1779, pp.107, 108. [88]

References on Suppressed Itch and Resulting Ailments

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 Méd., 1760, Sept., p. 211. Unzer, Arzt VI., St. 301. Hundertmark, as above, p. 33. Krause. Schubert, Diss. de scabie humani corp., Lips., 1779, p. 23. Karl Wenzel, as above, p. 174.

Melancholy Reil, memorab. Fasc., III., p. 177.

Insanity Landais in Roux, Journ. de Médecine, Tom. 41. Amat. Lusitanus, Curat. med. Cent. II., Cur. 74. J. H. Schulze, Brune, Diss. Casus aliquot mente alienatorum, Halle, 1707, Cas. I, p. 5. F. H. Waitz, medic.-chirurg. Aufsätze, Th. I, p. 130. Altenburg, 1791. Richter in Hufel. Journal, XV., II. Grossmann in Baldinger’s neuem Magaz., XI., I.

Case Studies on Suppressed Itch:

[89] A 20-year-old youth had his itch suppressed by a purgative that caused violent action for several days. For the next two years, he suffered daily from severe convulsions until the itch was brought back to the skin through the use of birch-juice.

[90] A 17-year-old male, robust and intelligent, developed hemoptysis (coughing up blood) three years ago, followed by epilepsy, after his itch had been suppressed. His condition worsened with medication until he experienced epileptic fits every two hours. Another surgeon managed to keep him free from epilepsy for four weeks using frequent blood-lettings and numerous medications. However, the epilepsy soon returned during his noonday nap, and he experienced two or three fits nightly. Concurrently, he developed a severe cough and suffocating catarrh, particularly at night, during which he expectorated a very foul-smelling fluid. He became bedridden. Despite extensive medication, his condition deteriorated, leading to ten fits at night and eight during the day. Remarkably, during these fits, he never clenched his thumbs or foamed at the mouth. His memory was impaired. Attacks tended to occur as mealtime approached, but more frequently after meals. During his nightly attacks, he remained in a deep sleep without waking, but in the morning, he felt bruised all over. The only warning sign of an impending fit was his rubbing his nose and drawing up his left foot, followed by a sudden collapse.

[91] After her itch was suppressed, a woman developed paralysis in one leg and remained lame.

[92] A 53-year-old man developed hemiplegia (paralysis of one side of the body) after his itch was suppressed with sulfur ointment.

[93] A minister, after long and unsuccessful attempts to treat his itch with internal remedies, eventually suppressed it with an ointment. Consequently, his upper extremities became partially paralyzed, and the palms of his hands developed hard, thick skin, full of bloody fissures (chaps) and unbearable itching. The same author also describes a woman whose fingers contracted due to itch suppressed by external means; she suffered from this condition for a long time.

[94] He observed a case of ‘idiotic melancholy’ (a severe form of depression with cognitive impairment) that arose following suppressed itch. When the itch reappeared, the melancholy vanished.

[95] A 20-year-old student suffered from ‘humid itch’ (an eczema-like condition) that so severely affected his hands he could no longer work. It was suppressed with sulfur ointment. Soon after, the profound impact on his health became evident. He developed insanity, singing or laughing inappropriately, and running until he collapsed from exhaustion. His mental and physical health deteriorated daily, eventually leading to hemiplegia (paralysis of one side of the body) and death. Post-mortem examination revealed his intestines were fused into a firm mass, dotted with small, ulcerated protuberances, some the size of walnuts, filled with a gypsum-like substance.

[96] [Translator’s Note: This refers to the same case described in footnote [95].]

[97] A 50-year-old man developed generalized dropsy (edema) after his itch was suppressed with ointments. When the itch reappeared, the swelling subsided, but he suppressed the itch again. This led to raving madness, with his head and neck swelling to the point of suffocation. Eventually, blindness and complete anuria (suppression of urine) developed. Artificial skin irritants and a strong emetic successfully brought the itch back. As the eruption spread over his entire body, all the previous severe symptoms disappeared.

Who, after considering even these few examples (which could be greatly expanded from the writings of physicians of that era and my own experience), could be so thoughtless as to overlook the profound evil lurking within – the Psora? The itch eruption and its other manifestations like tinea capitis, milk crust, and tetter are merely outward signs, local external symptoms that vicariously and mitigatingly indicate the internal, monstrous disease affecting the entire organism. Who, after reading even these few described cases, would hesitate to acknowledge that Psora, as previously stated, is the most destructive of all chronic miasmas? Who would be so stubborn as to declare, like later allopathic physicians, that itch eruptions, tinea, and tetters are merely superficial skin conditions? And that, therefore, they can be safely suppressed with external treatments because the body’s internal health remains unaffected?

Translator’s Note

An opponent from the old school has criticized me for not presenting my own experiences to prove that chronic illnesses, when not of Syphilitic or Sycotic origin, stem from the Psora miasma, arguing that such experiential proofs would have been more convincing. Oh! If the examples I’ve presented here, drawn from both older and modern non-Homœopathic writings, aren’t convincing enough, then what other examples (including my own) could possibly be considered more striking proof? How often (almost always, I might add) have opponents of the old school refused to believe the observations of honorable Homœopathic physicians? They dismiss them because these observations weren’t made directly before their eyes, and because patient names were only indicated by a letter – as if private patients would permit their full names to be used! Why should I tolerate such demands? And am I not proving my point in the most undeniable and unbiased way possible, through the experiences of so many other honest practitioners?

Indeed, among all the offenses committed by modern physicians of the old school, this is the most damaging, disgraceful, and unforgivable!

Anyone who, after considering the examples provided and countless others of a similar kind, refuses to acknowledge the precise opposite of that assertion is deliberately blinding themselves and intentionally contributing to the destruction of humanity.

Or are they so poorly informed about the nature of all miasmatic maladies associated with skin diseases that they fail to recognize their similar origin? Do they not know that all such miasmas first become internal diseases affecting the entire system before their external, alleviating symptom appears on the skin?

We will explain this process in more detail. Consequently, we will see that all miasmatic maladies presenting peculiar local skin ailments are always present as internal diseases within the system before their local symptom appears externally on the skin. However, only in acute diseases, after running their course over a certain number of days, do the local symptom and the internal disease tend to disappear, leaving the body free from both. In chronic miasmas, on the other hand, the external local symptom may either be suppressed from the skin or disappear spontaneously, while the internal disease, if left untreated, never entirely or partially leaves the system. On the contrary, it continuously worsens over the years, unless cured through proper treatment.

I must elaborate further on this natural process here, because conventional physicians, especially in modern times, are so lacking in insight—or, more accurately, so blind—that even though they could, so to speak, grasp and perceive this process in the origin and development of acute miasmatic eruptive diseases, they neither suspected nor observed a similar process in chronic diseases. Consequently, they declared these local symptoms to be secondary growths or mere external impurities on the skin, without any underlying internal disease. This applies to the chancre and the fig-wart, as well as to the eruption of itch. And therefore—since they overlooked the primary disease or perhaps even boldly denied its existence—by merely treating and destroying these local ailments externally, they have brought immeasurable suffering upon humanity.

The Three Stages of Miasmatic Disease Development

Regarding the origin of these three chronic maladies, just as in acute miasmatic eruptive diseases, three distinct and important stages must be considered more carefully than before: First, the time of infection; second, the period during which the entire organism is permeated by the infused disease until it has fully developed internally; and third, the emergence of the external ailment, through which nature externally demonstrates the completion of the internal development of the miasmatic malady throughout the whole organism.

Infection with miasmas—whether for acute diseases or the chronic ones mentioned earlier—undoubtedly occurs in a single, specific moment: the one most favorable for transmission.

When smallpox or cowpox takes hold, this happens the instant that, during vaccination, the diseased fluid in a bloody skin scratch contacts an exposed nerve. This contact irrevocably and dynamically transmits the disease to the vital force (the entire nervous system) at that very moment. After this moment of infection, no amount of washing, cauterizing, burning, or even cutting off the infected part can destroy or reverse the disease’s internal development. Smallpox, cowpox, measles, etc., will nonetheless complete their course internally, and the characteristic fever for each will erupt, along with its specific manifestations (smallpox, cowpox, measles, etc.), after a few days, once the internal disease has fully developed.

[*] We can rightly ask: Is there any miasma in the world that, once it infects from the outside, doesn’t first sicken the entire organism before its external signs appear? The only answer is: no, there isn’t! Doesn’t it take three, four, or five days after vaccination is performed before the vaccinated spot becomes inflamed? Doesn’t the characteristic fever—a sign that the disease has completed its internal development—appear even later, when the protective pock has fully formed, typically on the seventh or eighth day? Doesn’t it take ten to twelve days after smallpox infection before the inflammatory fever and the outbreak of smallpox on the skin occur? What has nature been doing with the infection received during these ten or twelve days? Wasn’t it necessary to first integrate the disease throughout the entire organism before nature was able to ignite the fever and produce the eruption on the skin? Measles also requires ten or twelve days after infection or inoculation before its eruption and fever appear. After scarlet fever infection, seven days usually pass before scarlet fever, with its characteristic skin redness, erupts. What, then, did nature do with the contracted miasma during the intervening days? What else but to fully integrate the entire disease of measles or scarlet fever throughout the living organism before completing the process, thereby enabling her to produce measles and scarlet fever with their eruptions?

The same holds true—not to mention several other acute miasmas—when human skin is contaminated with blood from cattle infected with anthrax. If, as is frequently the case, the anthrax infection has taken hold, all skin washings are useless. The black or gangrenous blister, which is almost always fatal, nonetheless appears after four or five days (usually at the site of infection). This occurs as soon as the entire living organism has transformed itself to this terrible disease.

The Nature of Miasmatic Infection

This principle also applies to the infection of certain “half-acute miasmas” that do not immediately produce eruptions. For instance, among many individuals bitten by rabid dogs, fortunately, only a few become infected—rarely more than one in twelve; often, as I myself have observed, only one out of twenty or thirty bitten individuals. The others, even if severely mauled by the mad dog, usually recover completely, even without medical or surgical intervention. [*]

However, in those individuals where the poison does take effect, it is established the moment the person is bitten. The poison then spreads to the nearest nerves and, consequently, to the entire nervous system. Once the disease has fully developed throughout the organism (a process that requires at least several days, often many weeks, for the disease to fully manifest), the madness (hydrophobia) erupts as an acute, rapidly fatal illness.

If the mad dog’s venomous saliva has indeed taken hold, the infection is usually irrevocably established at the moment of contagion. Experience shows that even immediate excision [**] or amputation of the bitten part does not prevent the internal progression of the disease or the eventual onset of hydrophobia. Consequently, the hundreds of other highly praised external methods for cleansing, cauterizing, or promoting suppuration of the bite wound are equally ineffective in preventing the outbreak of hydrophobia.

Footnotes:

[*] We are especially indebted to diligent English and American physicians for these valuable insights, including HUNTER and HOULSTON (in London Med. Journal, Vol. I.), and VAUGHAN, SHADWELL, and PERCIVAL, whose observations are recorded in James Mease’s “On the Hydrophobia, Philadelphia, 1793.”

[**] An eight-year-old girl in Glasgow was bitten by a mad dog on March 21, 1792. A surgeon immediately and completely excised the wound, promoted suppuration, and administered mercury until it produced a mild salivation, which was maintained for two weeks. Nevertheless, hydrophobia broke out on April 27, and the patient died on April 29. (M. DUNCAN’S Med. Comment, Dec. II., Vol. VII., Edinb. 1793, and The New London Med. Journ., II.)

From the progression of all these miasmatic diseases, we can clearly see that after external contagion, the associated disease must first develop internally throughout the entire person. This means the entire internal system must first be thoroughly affected by smallpox, measles, or scarlet fever before their characteristic eruptions can appear on the skin.

For all these acute miasmatic diseases, the human constitution typically has a beneficial process: it eliminates them (meaning the specific fever and eruption) within two to three weeks. The body naturally resolves them through a kind of crisis, expelling them from the organism. Consequently, people usually recover completely and quickly, unless the disease proves fatal.[*]

[*] Or do these various acute, ‘half-spiritual’ miasmas possess a unique characteristic? After penetrating the vital force at the initial moment of contagion (each causing disease in its own way), they then, like parasites, rapidly grow within the body. They typically manifest through their characteristic fever, and after producing their ‘fruit’ (the mature skin eruption capable of generating more miasma), they eventually die out, leaving the living organism free to recover?

Conversely, aren’t the chronic miasmas disease-parasites that persist as long as the infected person lives? Their ‘fruit’ appears as the initial eruptions they produce (the itch-pustule, the chancre, and the fig-wart), which are themselves capable of infecting others. Unlike acute miasmas, chronic miasmas do not die out on their own. They can only be eradicated and destroyed by a ‘counter-infection’ – a medicinal disease that is quite similar to the miasma but stronger (like an anti-psoric remedy), thereby freeing the patient and restoring their health?

The Nature of Chronic Miasmas

In chronic miasmatic diseases, nature follows a similar pattern regarding the mode of contagion and the initial development of the internal disease, before its external, visible symptoms appear on the body’s surface. However, a significant difference from acute diseases then becomes apparent: in chronic miasmas, the entire internal disease, as previously mentioned, persists within the organism throughout life. Indeed, it worsens each year unless it is eradicated and thoroughly cured by medical art.

Specific Chronic Miasmas: Syphilis and Psora

[Translator’s Note: Hahnemann refers to the manifestations of Syphilis (venereal chancre) and Psora (the itch) as the miasmas themselves, or as their most direct and recognizable forms for discussion.]

For this discussion, I will focus on two chronic miasmas that we understand more precisely: the venereal chancre and the itch.

During unprotected sexual intercourse, the specific contagion most likely arises at the exact moment and spot of contact and friction.

If this contagion takes hold, the entire living body subsequently becomes affected. Immediately after the moment of contagion, the venereal disease begins to form throughout the body’s interior.

In the sexual organs where the infection occurred, nothing unnatural—nothing diseased, inflamed, or corroded—is noticed in the first few days. Similarly, all washing and cleansing of the parts immediately after unprotected sexual intercourse is futile. The affected spot appears healthy; only the internal organism is activated by the infection (which usually happens instantly) to absorb the venereal miasma and become thoroughly diseased with the venereal malady.

Only when the disease has fully permeated all organs, when the entire person has become thoroughly venereal—meaning, when the venereal disease has fully developed—only then does the diseased organism attempt to alleviate and soothe the internal affliction by manifesting a local symptom. This symptom first appears as a vesicle (typically at the initial infection site), which then develops into a painful ulcer known as the chancre. This chancre usually appears five, seven, or fourteen days after infection, though occasionally, and more rarely, it may take three, four, or even five weeks. This chancre ulcer clearly serves as a substitute or ‘vicarious’ manifestation for the internal illness. It is produced internally by the organism once it has become thoroughly venereal, and through contact, it can transmit the same miasma (i.e., the venereal disease) to others.

Now, if the entire disease, once it has manifested, is eradicated by an internally administered specific remedy, then the chancre also heals, and the person recovers.

But if the chancre is destroyed by local applications [*] before the internal disease is cured—a practice still common among physicians of the old school—the miasmatic chronic venereal disease persists in the organism as Syphilis. If not cured internally, it worsens year after year until the end of the person’s life, with even the strongest constitution unable to eliminate it.

[*] The venereal disease erupts not only when the chancre is removed by cautery—a situation where some misguided casuists have attributed Syphilis to the ‘driving back’ of the poison from the chancre into the body’s interior, which they mistakenly believed was healthy until that point—no, even after the swift removal of the chancre without any external stimulants, the venereal disease still erupts. This provides further confirmation, if any were needed, of the undeniable pre-existence of Syphilis within the system. “Petit amputated a portion of the labia minora where a venereal chancre had been present for several days; the wound healed, but the venereal disease still manifested.” M. s. Fabre, Lettres, supplément à son traité des maladies vénériennes, Paris, 1786. Naturally! This is because the venereal disease was already present throughout the entire body even before the chancre appeared.

Only by curing the venereal disease, which permeates the entire body (as I have taught and practiced for many years), will the chancre—its local symptom—also be simultaneously and most effectively cured. Ideally, this occurs without any external applications for its removal. In contrast, merely destroying the chancre locally, without a prior general cure and liberation of the person from the internal disease, inevitably leads to the outbreak of Syphilis with all its associated sufferings.

Psora, like Syphilis, is a chronic miasmatic disease, and its origin and development are similar.

However, Psora is also the most contagious of all chronic miasms, far more infectious than the other two chronic miasms: Syphilis and Sycosis. Infection with these latter miasms requires a certain amount of friction in the most sensitive, nerve-rich areas of the body, covered by the thinnest skin, such as the genital organs, unless the miasm touches an open wound. But the Psora miasm only needs to touch the general skin, especially in sensitive children. Almost everyone is susceptible to the Psora miasm under nearly all circumstances, which is not true for the other two miasms.

No other chronic miasm infects more broadly, more certainly, more easily, and more completely than Psora; as previously mentioned, it is the most contagious of all. It is transmitted so easily that even a physician, rushing from one patient to another, might unconsciously [*] inoculate others while feeling their pulse. Laundry that has been washed with items infected with Psora; [**] new gloves tried on by a Psora patient; a shared lodging; a communal towel used for drying oneself – all have been known to transmit this spark of contagion. Indeed, a newborn baby is often infected while passing through the birth canal of an infected mother (which is not uncommon). Or the infant contracts this unfortunate infection from the midwife’s hand, which may have been contaminated by another birthing woman (or earlier). Or, again, a nursing infant may be infected by its nurse, or, while in her arms, through her caresses or the caresses of a stranger with unclean hands. This doesn’t even account for the thousands of other potential ways objects contaminated with this invisible miasm can come into contact with a person throughout their life, often in ways that cannot be foreseen or prevented. Consequently, individuals who have never been infected by Psora are truly the exception. We don’t need to search for the causes of infection only in crowded hospitals, factories, prisons, orphanages, or the squalid huts of the poor. Even in active life, in retirement, and among the wealthy, Psora stealthily infiltrates. The hermit on Montserrat escapes it as rarely in his rocky cell as the young prince in his fine cambric swaddling clothes.

[*] CAR. MUSITANI, Opera de tumoribus, Cap. 20.

[**] As WILLIS has noticed in TURNER, des maladies de la peau, traduit de l’anglais, à Paris, 1783, Tom. II., Cap. 3, p. 77.

The moment the miasma of itch, for example, touches the hand and takes effect, it no longer remains localized. From that point on, all washing and cleansing of the affected spot achieve nothing. Nothing is visible on the skin during the first few days; it remains unchanged and outwardly healthy. During these days, no eruption or itching is noticeable anywhere on the body, not even on the infected spot. The nerve initially affected by the miasma has already dynamically and invisibly transmitted it to the nerves throughout the rest of the body. The living organism has, unperceived, been so thoroughly permeated by this specific excitation that it is gradually compelled to assimilate this miasma until the entire being is transformed into a thoroughly psoric individual, and the internal development of the Psora is complete.

Only when the entire organism is transformed by this peculiar chronic-miasmatic disease does the diseased vital force attempt to alleviate and soothe the internal illness by manifesting a suitable local symptom on the skin: the itch-vesicles. As long as this eruption continues in its normal form, the internal Psora, with its secondary ailments, cannot erupt but must remain suppressed, dormant, latent, and contained.

Usually, it takes six, seven, ten, or perhaps even fourteen days from the moment of infection before the transformation of the entire internal organism into Psora is complete. Only then, after a slight or more severe chill in the evening and a general heat, followed by perspiration the following night (a minor fever that many attribute to a cold and thus ignore), does the outbreak of itch-vesicles occur. These are initially fine, resembling a miliary rash, but later enlarge on the skin [*] – appearing first in the region of the initially infected spot. This is accompanied by a voluptuously tickling itch, which can be described as ‘unbearably agreeable’ (Grimmen), and which so irresistibly compels the patient to rub and scratch the itch-vesicles that if a person forcibly restrains themselves from rubbing or scratching, a shudder runs over the skin of their entire body. While this rubbing and scratching provides some relief for a few moments, it is immediately followed by a prolonged burning sensation in the affected area. This itching is most frequent and most unbearable late in the evening and before midnight.

[*] Far from being an independent, merely local skin disease, the vesicles or pustules of itch are reliable proof that the internal Psora is already complete, and the eruption is merely an integral part of it. This peculiar eruption and itching form part of the essence of the entire disease in its natural, least dangerous state.

Initially, the vesicles of itch contain a clear, watery lymph. However, this quickly turns into pus, filling the tip of the vesicle.

The intense itching not only forces the patient to rub, but, as mentioned, to rub and scratch the vesicles open. The fluid that is squeezed out provides ample material to infect the patient’s surroundings and other uninfected individuals. Even imperceptible contamination of the extremities with this lymph, as well as contact with contaminated laundry, clothes, and various utensils, can spread the disease.

Only specific skin manifestations of Psora, which has permeated the entire organism, can spread the disease to others. These include the itch eruption itself (which is the most perceptible form), the sores that develop later with their characteristic Psora itching borders, herpes (or ’tetter’) that exhibits this peculiar itching and becomes moist when rubbed, and tinea capitis. These alone contain the communicable miasma of Psora. However, the other secondary symptoms of Psora – the general psoric ailments that appear after the eruption has vanished or been artificially suppressed – cannot transmit the disease to others. To our knowledge, they are no more capable of transferring Psora than the secondary symptoms of venereal disease can infect others with Syphilis (as first observed and taught by J. Hunter).

When the itch eruption has just appeared and is not yet widespread on the skin, the patient typically shows no signs of the general internal Psora illness. The skin eruption acts as a substitute for the internal disease, keeping Psora and its secondary ailments, as it were, latent and contained. [*]

[Translator’s Note: The original text uses “emotional symptom,” which might be an archaic term or a mistranslation. Based on the context of the preceding sentence (“itch-eruption”) and the subsequent footnote about the chancre (a physical lesion) acting “vicariously,” it is understood that Hahnemann is referring to the external skin manifestation acting as a substitute for the internal disease. Therefore, “skin eruption” or “external manifestation” is used for clarity.]

[*] Just as a chancre, if not removed, acts vicariously and alleviates the internal Syphilis, preventing the venereal disease from fully manifesting as long as it remains undisturbed. I once examined a woman who showed no secondary symptoms of venereal disease. A chancre had remained untreated in its original location for two years, gradually growing to nearly an inch in diameter. The best preparation of Mercury, administered internally, quickly and completely healed not only the internal illness but also the chancre.

In this initial stage, the disease is most easily cured with specific remedies administered internally.

However, if the disease is allowed to progress naturally, without an internal curative remedy or an external application to suppress the eruption, the internal disease rapidly intensifies. This increase in the internal illness necessitates a corresponding increase in the skin symptoms. Consequently, the itch eruption must spread, eventually covering the entire body surface, to soothe and keep the intensified internal disease latent.

Yet, even at this peak of the disease, the patient still appears healthy in every other respect. All the symptoms of the internal Psora, now greatly intensified, remain hidden and alleviated by the proportionally increased skin symptom. But such intense agony, caused by an unbearable itching spread over the whole body, is more than even the most robust person can continue to bear. They try to free themselves from this suffering at any cost. Since conventional physicians offer no effective help, they endeavor to find relief from this unbearably itchy eruption, even if it means risking their life. Means to achieve this are soon provided, either by uninformed individuals or by allopathic physicians and surgeons. The patient seeks deliverance from external torment, unaware of the greater misfortune which unavoidably follows—and is bound to follow—the expulsion of the external skin symptom (which until now acted as a substitute for the internal, aggravated Psora disease), as has been amply demonstrated by previous observations. But by suppressing such an itch eruption with external applications, they expose themselves to a similar misfortune, acting as foolishly as someone who, to quickly escape poverty and supposedly find happiness, steals a large sum of money, only to end up in prison and on the gallows.

The longer the itch disease has persisted—whether the eruption has spread over most of the skin (as is usually the case) or, due to an unusual lack of activity in the skin (as in some cases), the eruption has been confined to a few itch vesicles [*]—in both scenarios, assuming the Psora, along with its skin symptom, has become chronic, the expulsion of the itch eruption, regardless of its size, leads to the most destructive consequences. This is because the internal itch disease (Psora), with its unimaginable suffering, has intensified significantly due to its long duration and then inevitably erupts.

[*] See the observation for No. 86, page 29.

The Dangers of Suppressing Chronic Diseases

The ignorance of an uninstructed layman may be forgiven for suppressing an itch-eruption and its troublesome itching with a cold shower, by rolling in the snow, by cupping, or by rubbing the skin (or just the skin around the joints) with sulphur mixed with lard. After all, he doesn’t know what dangerous complications and flare-ups of the underlying Psora he unwittingly invites. But how can we forgive physicians whose professional duty it is to understand the inevitable and far-reaching consequences of externally expelling an itch-eruption, especially when the Psora is then stirred up throughout the entire organism? They should have prevented this by thoroughly curing the entire disease internally. Yet, we see them treat patients with itch in the same misguided way, often using even harsher internal and external remedies: strong purgatives, Jasser ointment, lead acetate lotions, mercury sublimate or zinc sulfate, and especially ointments made from fat with flowers of sulphur or mercury preparations. With these, they casually and carelessly eliminate the eruption, proclaiming, “This is merely a superficial skin impurity that must be expelled; then everything will be fine, and the person will be healthy and free from all ailments.”

Hahnemann’s Elaboration on the Cure of Itch and Chancre

Even when the itch-disease has reached an advanced stage, the eruption, along with the internal malady—in a word, the entire Psora—can still be healed by internal, specific Homœopathic remedies. This is certainly more difficult than if treated immediately after its onset, but still far more easily and reliably than after the eruption has been completely suppressed by external applications alone. In the latter case, we are then forced to treat the internal Psora as it manifests its secondary symptoms and evolves into countless chronic diseases. Even when the itch-disease has progressed significantly, it can still be most easily, reliably, and thoroughly cured in its entirety, including its external eruption, using appropriate internal remedies, without any local application whatsoever.

Similarly, venereal chancre disease can often be most surely and easily cured thoroughly by even the smallest, single dose of the best mercury preparation administered internally. In such cases, the chancre, without further intervention, quickly transforms into a mild ulcer and heals on its own within a few days. Consequently, no trace of secondary symptoms (venereal disease) ever appears, because the internal disease has been cured along with the local symptoms. I have taught this for many years, both orally and in my writings, and have proven it through my successful cures.

How can we excuse the entire medical profession who, after treating this widespread venereal disease for over three hundred years, still remain so ignorant of its true nature? Even today, when they observe a chancre, they recognize nothing diseased in the infected patient other than the chancre itself. They fail to see the Syphilis that was already present internally and had developed throughout the entire organism even before the chancre appeared. So, they blindly assume that the chancre is the sole venereal affliction to be eradicated, and that merely destroying it with external applications is sufficient to declare the patient cured. This is despite thousands of cases in their experience demonstrating that locally eradicating the chancre has always caused harm. They have merely stripped the pre-existing internal Syphilis of its diverting local symptoms, thereby forcing the internal disease to manifest more certainly and dreadfully (and in a way that is harder to cure) as venereal disease. How can such a widespread, harmful distortion of understanding be excused?

Or why did these physicians never consider the origin of figwarts? Why did they consistently overlook the underlying systemic illness that causes these growths? Only when this internal cause is recognized can it be thoroughly cured by its Homœopathic remedies, which then lead to the healing of the figwarts without any external destructive measures.

Even if the slightest excuse could be offered for this regrettable negligence and ignorance—if one were to argue that these physicians have only had three and a half centuries to clearly discern the true nature of Syphilis, and that they might have learned this truth after even more extensive practice (though I have, in vain, tried to convince them of their error for many years, and continue to do so from time to time)—nevertheless, the widespread negligence of past physicians, and I might even say their stubborn blindness, are entirely inexcusable. They failed to recognize the internal, pre-existing malady—the Psora—which underlies the itch-disease that has afflicted humanity for thousands of years. In their arrogant dismissiveness, they ignored all evidence pointing to it, simply to perpetuate the delusion and leave the world in its destructive infatuation: that unbearably itching pustules are merely a superficial skin ailment, and that by locally destroying them, a person is cured of the entire disease and has fully recovered.

It wasn’t just obscure medical writers; no, the greatest and most celebrated physicians of both modern and contemporary times have been guilty of this grave error (or dare I say, this intentional crime), from VON HELMONT right up to the latest proponents of Allopathic medical practice.

By using the aforementioned remedies, they usually achieved their immediate goal: suppressing the eruption and itching from the skin. In their self-congratulatory delusion (or at least they pretended), they believed they had completely destroyed the disease itself. They then sent away these mistreated patients, assuring them they were healthy again.

All the sufferings that followed the one-sided destruction of the cutaneous eruption—which is a natural manifestation of the Psora—they dismissed as a newly developed disease stemming from an entirely different cause. With their limited perspective, they consistently ignored the countless clear testimonies from honest observers of earlier times. These testimonies documented the tragic consequences of locally suppressing the itch-eruption, consequences that often followed so closely that one would have to deny reason itself not to acknowledge them as the direct result of the severe internal malady (the Psora). This internal disease, deprived of its local symptom (the skin eruption)—which nature intended to alleviate the internal suffering—was then forced to manifest a clear outbreak of its secondary symptoms.

How can we excuse those who refuse to learn from the numerous cautionary examples documented by older, more diligent observers, or from the thousands of other cases they witness frequently, almost daily? Yet, they fail to see or be convinced of the certain, quickly fatal, or lifelong insidious misfortune they inflict upon the itch-patient by suppressing their eruption. In doing so, they merely unleash the internal malady (Psora), which is burdened with countless ailments. This disease is neither destroyed nor cured. Instead of being conquered, this thousand-headed monster is inexorably unleashed against the deceived patient, leading to their destruction, simply by tearing down the barriers that confined it.

Experience shows, as one might easily imagine, that the longer a neglected itch eruption has persisted on the skin, the more certainly the underlying internal Psora has been able to reach a significant, and eventually its highest, degree in even a moderate amount of time. This alarming progression is evident from the more dangerous consequences that inevitably follow the suppression of such a deeply rooted eruption in every case.

Conversely, it is equally certain that an eruption of a few itch vesicles, which appeared only a few days prior due to a recent infection, can be suppressed with less immediate danger. This is because the internal Psora, having just emerged in the entire organism, has not yet had time to develop to a high degree. Indeed, we must acknowledge that suppressing a newly appeared itch eruption often shows no immediate, overtly severe, negative consequences. Consequently, among delicate and aristocratic individuals, or their children, it often goes unrecognized that a single intensely itching vesicle, or a few such vesicles, which appeared for only a few days and were promptly treated by a careful physician with lead ointment or a lead lotion, disappearing the next day, were actually based on itch.

No matter how minor the internal Psora may be at the time of rapid suppression of an itch eruption that has only produced a few vesicles, and which is then followed by only moderate ailments and complaints (often ignorantly attributed by the family physician to other minor causes): this internal Psora, though still slight, retains its fundamental character and chronic nature as the same general psoric disease affecting the entire organism. That is, without proper medical intervention, it is incurable and cannot be eradicated by even the strongest and healthiest constitution; it will continue to worsen throughout the patient’s life. Indeed, it is usually the case that when this disease’s initial skin symptoms are removed as early as possible by local applications, it will progress slowly within the organism at first—much slower than if the eruption had been allowed to remain on the skin for a long time, in which case the internal Psora progresses with immense rapidity. Nevertheless, the disease steadily worsens, even in the best and most favorable circumstances, often quietly and unnoticed for years. Consequently, anyone unfamiliar with the signs of its hidden presence would consider such individuals healthy and free from any internal illness. For years, it often does not manifest itself through prominent symptoms that could be termed overt diseases.

Through hundreds of observations, I have gradually become familiar with the signs by which internally dormant, previously hidden Psora (the itch-malady) can be recognized, even before it manifests as any striking disease. This knowledge allows me to eradicate and thoroughly cure this illness from its very roots more easily, before the internal Psora develops into a manifest (chronic) disease and reaches such a severe stage that its dangerous complications make treatment difficult, and in some cases, impossible.

*[Footnote ] It was easier for me than for many others to identify and recognize the signs of Psora, both when it was latent and dormant internally, and when it had progressed to significant chronic diseases. I achieved this by carefully comparing the health status of all such individuals with my own. Unusually, I have never been afflicted with Psora, and therefore, from birth until my eightieth year, I have been entirely free from the various ailments (both minor and major) described here and later. This is despite being generally susceptible to acute epidemic diseases and having endured numerous mental exertions and countless emotional distresses.

**[Footnote ] Allopathy has also posited hidden (latent) disease conditions in patients, either to explain or at least to excuse its indiscriminate interventions with harsh medicines, blood-letting, pain relievers (anodynes), and so forth. However, these so-called ‘Fernel’s occult qualities’ (qualitates occultæ Fernelii) are entirely speculative and imaginary. According to Fernel himself, they are supposedly not recognizable by any manifestations or symptoms. But for us humans, whose understanding of things is limited by our Creator to observations, anything that does not reveal its hidden, imaginary existence through any sign simply does not exist. It is, consequently, merely a figment of a wandering imagination. This is quite different from the various forces that lie dormant (latent) in nature. Despite their usual hiddenness, they nonetheless reveal themselves when the necessary circumstances and conditions arise. For example, latent heat, even in metals that feel cold, becomes manifest when they are rubbed, much like Psora manifests itself—for instance, as a drawing pain in the muscle sheaths when a person infected with Psora has been exposed to a draught.

There are many signs of Psora gradually increasing internally, yet still dormant and not yet having fully erupted into a manifest disease. However, no single person exhibits all these symptoms. One individual may have more of them, another fewer. Someone might currently have only one symptom, but over time, others will appear. They may be free from some symptoms, depending on their unique bodily disposition or external circumstances.

Symptoms of Latent Psora

Primarily in children: frequent expulsion of ascarides and other worms, causing unbearable itching in the rectum.

The abdomen is often distended.

Alternating between insatiable hunger and a complete lack of appetite.

Paleness of the face and muscle relaxation.

Frequent eye inflammations.

Swelling of the cervical glands (scrofula).

Sweating on the head, especially in the evening after falling asleep.

Nosebleeds (epistaxis) in girls and youths (less common in older individuals), often quite severe.

Typically cold hands or sweating palms, sometimes accompanied by a burning sensation in the palms.

Cold, dry, or foul-smelling sweaty feet, sometimes with a burning sensation in the soles.

The arms, hands, legs, or feet become numb from even a minor cause.

Frequent cramps in the calves, and sometimes in the muscles of the arms and hands.

Painless, involuntary twitching (subsultus) of various muscle groups throughout the body.

Frequent or persistent dry or runny coryza or catarrh, [*] or, paradoxically, an inability to catch a cold even after severe exposure, despite otherwise experiencing these kinds of ailments constantly.

[Translator’s Note: The footnote clarifies that widespread epidemic catarrhal fevers and catarrhs, like Grippe or Influenza, which affect almost everyone, including healthy individuals, are not considered part of this category of Psora symptoms.] [*] The epidemic catarrhal fevers and catarrhs that affect almost everyone, even the healthiest individuals (such as Grippe or Influenza), do not fall into this category.

Prolonged obstruction of one or both nostrils.

Ulcerated nostrils (a sore nose).

An unpleasant sensation of dryness in the nose.

Frequent throat inflammation and hoarseness.

Short, tickling cough (tussiculation) in the morning.

Frequent attacks of shortness of breath (dyspnea).

A strong predisposition to catching colds (affecting either the entire body or specific areas like the head, throat, chest, abdomen, or feet; for instance, from a draught [*]), especially when these parts tend to perspire, leading to many other, sometimes long-lasting ailments.

[Translator’s Note: This footnote explains that individuals not afflicted with Psora, while they might find draughts and damp cold air uncomfortable, do not typically develop colds or adverse after-effects from such exposures.] [*] Individuals not afflicted with Psora, though they may find draughts and damp cold air disagreeable, do not typically suffer from colds or other negative after-effects from them.

• A tendency to muscle strains, even from carrying or lifting light objects, or simply by stretching upwards and reaching for high-hung items. This can also lead to a variety of complaints from moderate muscle stretching, such as headache, nausea, extreme weakness (prostration), and a tight, pulling pain in the neck and back muscles.
• Frequent headaches or toothaches, often affecting one side of the head, triggered even by moderate emotional upset.
• Frequent hot flashes and facial redness, often accompanied by anxiety.
• Frequent hair loss, with dry hair and a scaly scalp.
• Occasional susceptibility to erysipelas.
• Amenorrhea (absence of menstruation), or irregular periods that are too heavy, too light, too early (or too late), too prolonged, or too watery, often accompanied by various other physical complaints.
• Limb twitching when falling asleep.
• Feeling tired early upon waking; sleep that doesn’t feel restorative.
• Morning perspiration while still in bed.
• Excessive daytime perspiration, even with minimal movement (or, conversely, an inability to perspire).
• A white or very pale tongue; even more commonly, a cracked tongue.
• Excessive phlegm in the throat.
• Frequent or almost constant bad breath, particularly in the early morning and during menstruation. This odor can be perceived as bland, slightly sour, like an upset stomach, moldy, or even putrid.
• A sour taste in the mouth.
• Morning nausea.
• A feeling of emptiness in the stomach.
• Aversion to cooked, warm food, especially meat (primarily observed in children).
• Aversion to milk.
• Dryness in the mouth, either at night or in the morning.
• Frequent or daily cutting pains in the abdomen (especially in children), often worse in the morning.
• Hard stools, typically delayed for more than a day, clotted, and often covered with mucus (or, conversely, almost consistently soft, fermenting stools resembling diarrhea).
• Venous knots (hemorrhoids) on the anus; blood passed with stools.
• Passage of mucus from the anus, with or without feces.
• Anal itching.

Dark urine.

Swollen, enlarged veins on the legs (varicose veins).

Chilblains and chilblain-like pains, even outside of severe winter cold, sometimes even in summer.

Corn-like pains, even without any external pressure from shoes.

A tendency for joints to crack, strain, or wrench easily.

Cracking sounds in one or more joints when moving.

Drawing, tense pains in the neck, back, and limbs, especially in the teeth (aggravated by damp, stormy weather, northwest and northeast winds, after colds, overexertion, or unpleasant emotions).

Pains and complaints worsen at rest and disappear with motion.

Most ailments appear at night and are aggravated by a low barometer, north and northeast winds, in winter, and towards spring. [Translator’s Note: In Europe, northeast winds are cold, sharp, and dry, corresponding to what we might call west winds.]

Uneasy, frightening, or at least overly vivid dreams.

Unhealthy skin; even minor lesions turn into sores, with cracked skin on the hands and lower lips.

Frequent boils and felons (whitlows).

Dry skin on the limbs, arms, thighs, and sometimes on the cheeks.

Occasional rough, scaling spots on the skin that cause an intensely pleasurable itching, followed by a burning sensation after scratching.

Occasionally, though seldom, a single, unbearably itchy vesicle appears, sometimes filled with pus at its tip, causing a burning sensation after scratching, found on a finger, wrist, or elsewhere.

Despite experiencing several or many of these ailments (even at different times and frequently), a person might still consider themselves healthy, and others may perceive them as such. They might even lead a quite tolerable life in this state, attending to their business without much hindrance, especially if they are young or in their prime, have a satisfactory income, avoid external misfortunes, live free from vexation or grief, do not overexert themselves, and possess a cheerful, even-tempered, patient, and contented disposition. In such individuals, Psora (the internal itch malady), which an expert can recognize by some or many of the symptoms listed above, may lie dormant for many years without causing a continuous chronic disease.

However, even in such favorable external circumstances, as these individuals age, even minor triggers (a slight annoyance, a cold, or a dietary mistake, etc.) can provoke a violent, though brief, disease attack. This might manifest as severe colic, inflammation of the chest or throat, erysipelas, fever, and similar conditions. The intensity of these attacks often appears disproportionate to their seemingly minor causes. This typically occurs in autumn or winter, but frequently also in spring.

But even when an individual, child or adult, harbors a dormant Psora and appears largely healthy, if they encounter circumstances contrary to the favorable conditions mentioned earlier—and their health and entire organism are significantly weakened and shaken by a widespread epidemic fever or an infectious acute disease (such as smallpox, measles, whooping cough, scarlet fever, purple rash, etc.), or by a severe external injury (a shock, a fall, a wound, a significant burn, a broken arm or leg), strenuous labor, confinement due to illness (often exacerbated by incorrect and debilitating Allopathic treatment), or a sedentary occupation in a gloomy, confined room that saps their vital force; or if they suffer the sorrowful loss of beloved relatives that crushes their spirit with grief, or daily vexation and annoyance that embitters their life; or if they experience food deterioration or a complete lack of essential and indispensable nourishment, exposure, and poor food that diminishes their courage and strength—then the Psora, which had been dormant until then, awakens. It manifests through the heightened and intensified symptoms described below, transitioning into severe illnesses. One or another of the countless (psoric) chronic diseases [**] erupts, and most notably, through the debilitating and exhausting improper treatment by allopathic physicians, these conditions are aggravated repeatedly and without pause, often reaching alarming severity, unless favorable external circumstances intervene to moderate the disease process.

[*] Following the resolution of an acute fever, an eruption of itch often appears, as if provoked by the fever, indicating the presence of an old, underlying Psora in the body. Physicians, however, explain this as a new generation of itch in a body supposedly ‘replete with bad humors’ (that is to say, full of unhealthy fluids), because they are unaware of Psora existing in humans in a long-dormant state. Yet, itch disease cannot spontaneously generate or arise anew, just as smallpox, cow-pox, measles, or venereal chancre disease cannot appear in any person without prior infection.

[**] The specific manifestation of the disease (one form or another) is influenced by the individual’s original bodily constitution, their unique lifestyle, their particular mental disposition (often shaped by education), or a more receptive or weakened state of a specific body part. These factors give the underlying itch disease a distinct direction, causing it to manifest preferentially in a certain way and develop into a particular modification. A passionate, irritable disposition creates an extraordinary predisposition for the development of Psora. Similarly, prior exhaustion from frequent pregnancies, excessive infant nursing, extreme hardships, debilitating incorrect medical treatment, debauchery, and a dissolute lifestyle also contribute. As previously mentioned, the internal itch-disease (Psora) is of such a peculiar nature that it can remain, so to speak, suppressed and concealed for a long time by favorable external conditions. Consequently, an individual might appear healthy to a casual observer for years, even many years, until circumstances detrimental to the body, the soul, or both, emerge. These unfavorable conditions then act as a hostile impulse, awakening the dormant disease within and allowing its germs to develop. Neither their acquaintances, their physician, nor even the patient themselves can then comprehend how their health could have declined so suddenly. From my own experience, here are some illustrative examples: After a simple limb fracture requiring five or six weeks of bed rest, other types of diseased conditions may follow, whose cause cannot be readily identified. Even when these conditions are seemingly alleviated, they invariably return, and even without any dietary errors, they show aggravation upon recurrence. This typically occurs in autumn (winter) and spring, evolving into a persistent ailment that worsens year after year. A lasting cure for such conditions, without replacing them with an even worse disease through Allopathic treatment, has been vainly sought by past physicians and through visits to mineral springs. In human life, there are countless such obstacles or unfavorable events that serve to awaken Psora (the internal itch-disease), which may have been dormant for a long time, causing its germs to develop. The grave ailments that gradually follow these events are often so disproportionate to the initial triggers that no rational person could consider those occurrences as sufficient causes for the subsequent chronic diseases, which are often terrifying in nature. Such a person is compelled to acknowledge a deeper, underlying hostile cause for these manifestations, a cause that has only now fully expressed itself.

Consider, for instance, a young married woman who, by all outward appearances and common standards, seemed healthy. However, she had been infected with Psora in her childhood. During her third month of pregnancy, she suffered a carriage accident. This resulted in not only minor injuries and severe fright but also a miscarriage. The subsequent blood loss significantly weakened her.

Within a few weeks, her youthful constitution had largely recovered, and she seemed on the path to lasting good health. However, news of a beloved sister’s dangerous illness, living far away, caused a relapse. This not only worsened her previous ailments, which hadn’t fully resolved, but also triggered a host of new nervous disorders and convulsions, escalating her condition into a serious illness. Eventually, better news arrived from her sister, followed by the joyful announcement of her full recovery. Finally, her completely restored sister came to visit her.

Despite this, the young wife remained ill. Even if she appeared to recover for a week or two, her ailments would inexplicably return. Each subsequent childbirth, even an easy one, and every harsh winter, added new problems to her existing ones, or transformed her previous disorders into even more distressing conditions. Ultimately, she developed a serious chronic illness. It was baffling why her youthful vitality, combined with a happy environment, hadn’t quickly overcome the effects of that single miscarriage. Even more perplexing was why the distressing impact of the sad news hadn’t vanished upon hearing of her sister’s recovery, or at least upon her sister’s actual presence, fully restored.

[Translator’s Note: Hahnemann uses this case to illustrate how an underlying chronic miasm (Psora), even when seemingly dormant, can be activated and perpetuated by acute stressors (accident, miscarriage, emotional shock), leading to a persistent chronic illness that doesn’t resolve even after the initial triggers are gone.]

If, as is natural, a cause must always be proportionate to its effect and consequences, then it’s impossible to understand how, after removing the factors damaging her health, the resulting ailments could not only persist but even worsen year after year, unless their true cause lay elsewhere, something deeper. Consequently, these unfortunate events (the miscarriage and the sad news), having resolved on their own, could not possibly be the sufficient cause for the ensuing chronic disease. Instead, they must be seen merely as the trigger, not the efficient cause, for the development of a more significant, hostile power that was already present within the organism but had been dormant until then.

In a similar manner, a robust merchant, apparently healthy despite some traces of internal Psora (discernible only to a professional examiner), may, in consequence of unfortunate business circumstances, become financially distressed, even to the brink of bankruptcy. At the same time, he will gradually fall into various ailments and finally into serious illness. However, the death of a rich kinsman and winning a great prize in a lottery more than cover his business losses; he becomes a man of means. Yet, his illness not only continues but increases year after year, despite all medical prescriptions and visits to the most famous baths—or rather, perhaps, because of these two causes.

A modest girl, who, apart from some signs of internal Psora, was considered quite healthy, was forced into a marriage that made her deeply unhappy. Proportionally, her physical health declined, without any trace of venereal infection. No allopathic medicine could alleviate her distressing ailments, which grew progressively more threatening. But in the midst of this aggravation, after one year’s suffering, the source of her unhappiness, her hated husband, was taken from her by death. She seemed to revive, convinced that she was now free from any cause of mental or physical illness, and hoped for a swift recovery. All her friends hoped the same for her, believing the exciting cause of her illness was now in the grave. She also improved speedily, but unexpectedly, she remained an invalid despite her youthful vigor. Indeed, her ailments rarely left her, recurring periodically without any external cause, and even worsening year after year during the colder months.

A person unjustly suspected and embroiled in a serious criminal suit, who had previously seemed healthy (apart from the aforementioned signs of latent Psora), developed various diseased states during these distressing months. Eventually, the accused’s innocence was acknowledged, leading to an honorable acquittal. One might suppose such a happy, gratifying event would necessarily revitalize the accused and eliminate all physical complaints. However, this did not happen. The person still suffered from these ailments periodically; they recurred with longer or shorter remissions and worsened with passing years, especially during the winter seasons.

How shall we explain this? If that disagreeable event had been the sufficient cause of these ailments, shouldn’t the effect—the disease—have necessarily ceased entirely once the cause was removed? But these ailments did not cease; they recurred over time and even gradually worsened. It became evident that those disagreeable events could not have been the sufficient cause of the present ailments and complaints. Instead, they merely served as an occasion and impetus for the development of a malady that had until then only slumbered within.

The Underlying Cause: Psora

The recognition of this frequently present ‘old internal foe’ and the science capable of overcoming it reveal that, generally, an indwelling itch (Psora) was the underlying cause of all these ailments. These cannot be overcome even by the vigor of the best constitution, but only through specific medical art.

Even if favorable external conditions temporarily check the rapid development of an erupted disease, true health cannot be lastingly restored by any treatment known to date. The conventional allopathic treatments, with their aggressive and unsuitable remedies—such as baths, mercury, prussic acid, iodine, digitalis, quinine, starvation, and other fashionable remedies—only hasten death, the inevitable outcome for maladies that physicians cannot truly cure.

Once, under the aforementioned unfavorable external circumstances, Psora transitions from its slumbering and bound condition to its awakening and outbreak, and the patient submits to the harmful practices of the typical allopathic physician—who, deeming it appropriate for his practice and income, mercilessly assaults the patient’s organism (as we regrettably observe daily) with the battering-rams of his violent, unsuitable remedies and debilitating treatments—in such a case, even if the patient’s external circumstances and surroundings have changed ever so favorably, the aggravation of the disease nevertheless progresses relentlessly under such care.

The awakening of the internal Psora, which has previously slumbered and remained latent, and, as if held in check by a good bodily constitution and favorable external circumstances, as well as its eruption into more serious ailments and diseases, is heralded by an increase in the symptoms previously described as indicative of slumbering Psora, and by a countless multitude of various other signs and complaints. These vary according to the individual’s bodily constitution, hereditary disposition, various errors in his upbringing and habits, his manner of living and diet, his employments, his mental disposition, his morality, and so on.

Then, when the itch disease develops into a clearly manifest secondary disease, the following symptoms appear. I have entirely derived and observed these from records of diseases I successfully treated, and which undeniably originated from itch contagion, unmixed with Syphilis or Sycosis.

I readily believe that others may have observed many more symptoms.

I would also add that among the symptoms presented, some are completely contradictory. This can be attributed to the diverse physical constitutions present when the internal Psora manifested. However, one type of symptom is observed less frequently than the other and does not pose any significant obstacle to a cure:

Head Symptoms

• Vertigo; staggering while walking.
• Vertigo; when closing the eyes, everything seems to spin around him; simultaneously, he is seized with nausea.
• Vertigo; when turning around quickly, he nearly falls.
• Vertigo, as if a sudden jerk in the head causes a momentary loss of consciousness.
• Vertigo with frequent burping.
• Vertigo even when merely looking down at level ground, or when looking upward.
• Vertigo while walking on an unenclosed road in an open plain.
• Vertigo; she perceives herself as alternately too large or too small, or other objects appear this way to her.
• Vertigo, resembling a faint.
• Vertigo, progressing into unconsciousness.
• Dizziness; inability to think or perform mental tasks.
• Her thoughts are uncontrollable.
• She is at times completely thoughtless (sits lost in thought).
• Open air causes dizziness and a heavy, drowsy feeling in the head.
• At times, everything appears dark and black before his eyes, especially while walking, stooping, or rising from a stooping posture.
• Rush of blood to the head. [1]
• Heat in the head (and face). [2]
• A cold pressure on the crown of the head. [3]
• Headache, a dull pain occurring immediately upon waking in the morning, or in the afternoon when walking rapidly or speaking loudly.
• One-sided headache, with a certain periodicity (after 28, 14, or fewer days), more frequently during the full moon or new moon, or after mental excitement, after a cold, etc.; a pressure or other pain on the crown of the head or deep inside it, or a boring pain over one of the eyes. [4]

Footnotes

Symptoms

• Daily headaches occurring at specific times, often described as a stitching pain in the temples. [1]
• Attacks of throbbing headache, for instance, in the forehead, accompanied by severe nausea, a sensation of impending collapse, or even vomiting. These attacks typically begin early in the evenings and recur every two weeks, or sometimes more or less frequently.
• Headache with a sensation as if the skull is about to burst open. [2]
• Headache characterized by drawing or pulling pains. [3]
• Headache with stitching pains in the head, sometimes extending out through the ears. [4]
• Various noises perceived in the head, such as roaring, singing, buzzing, humming, or thundering sounds.
• Scalp covered with dandruff, which may or may not be accompanied by itching.
• Eruptions on the head, including tinea capitis, or severe tinea with crusts of varying thickness. These areas experience sensitive stitching pains when they become moist, followed by intense itching. The entire crown of the head is painfully sensitive to open air, and hard glandular swellings in the neck are also present.
• Hair on the head appears parched or dry.
• Frequent hair loss, predominantly from the front, crown, and top of the head, leading to bald spots or the onset of baldness in specific areas.
• Painful lumps form under the skin, appearing and disappearing, resembling bumps or round tumors. [5]
• A sensation of contraction or tightness in the skin of the scalp and face.
• Facial paleness during the initial phase of sleep, accompanied by blue rings around the eyes.
• Frequent redness and heat in the face. [6]

Footnotes

Symptoms Affecting the Face and Eyes

Face The face appears yellowish or sallow. A sallow, yellowish complexion. Erysipelas (a skin infection) on the face. [1]

Eyes A feeling of pressure in the eyes, especially late in the evening, compelling the person to shut them. The person cannot gaze at anything for long; otherwise, objects appear to flicker or move before their eyes. The eyelids, particularly in the morning, feel as if they are sealed shut. The person cannot open them for minutes, or even hours. They feel heavy, as if paralyzed or spasmodically closed. The eyes are extremely sensitive to daylight, experiencing pain and closing involuntarily. [2] A sensation of coldness in the eyes. The canthi (corners of the eyes) are filled with pus-like mucus, often described as ’eye-gum’. The edges of the eyelids are coated with dry mucus. Inflammation of one or more Meibomian glands along the edges of the eyelids. Various types of eye inflammations. [3] Yellow discoloration around the eyes. Yellowing of the sclera (the white of the eye). [4] Dim, opaque spots appearing on the cornea. [5] Dropsy (edema or fluid retention) of the eye. Obscuration of the crystalline lens, leading to cataract formation. Squinting (strabismus). Far-sightedness (hyperopia): The person can see distant objects clearly but struggles to distinguish small objects held close. Short-sightedness (myopia): The person can see even small objects clearly when held close, but distant objects appear increasingly indistinct, becoming invisible at great distances. False vision (diplopia or polyopia): Objects appear double, multiple, or only half of them are visible. Floating specks before the eyes, such as ‘flies,’ black points, dark streaks, or networks, especially noticeable when looking into bright daylight. The eyes feel as if looking through a veil or mist, with vision becoming dim at certain times.

Eye and Vision Symptoms

Night Blindness: The patient sees well during the day but cannot see at all in twilight.

Day Blindness: The patient can only see well during twilight hours.

Amaurosis: Persistent dimness of vision [1], eventually progressing to complete blindness.

Facial Pain

Pain in various facial areas: Specific spots on the face, cheeks, cheekbones, and lower jaw are painful to touch. While chewing, there’s a sensation of internal festering, along with sharp, sudden pains (stitches and jerks). These jerks, stitches, and tension during chewing can be so severe that the patient cannot eat. [2]

Ear and Hearing Symptoms

Hypersensitive Hearing: Hearing is extremely irritated and sensitive. The patient cannot tolerate the sound of a bell ringing without trembling. The beating of a drum can trigger convulsions. Many sounds cause pain in the ear.

Ear Pain: Stinging pains in the outer ear. [3]

Ear Sensations: Crawling sensation and itching inside the ear.

Ear Dryness: The ear feels dry, with dry scabs inside and a complete absence of earwax.

Ear Discharge: Thin, often foul-smelling pus discharges from the ear.

Pulsation: A pulsating sensation in the ear.

Tinnitus: Various sounds and noises perceived in the ear. [4]

Deafness: Hearing loss of varying degrees, up to complete deafness, which may or may not be accompanied by noises in the ear. This condition occasionally worsens depending on the weather.

Parotid Gland Swelling: Swelling of the parotid glands. [5]

Nose and Smell Symptoms

Epistaxis (Nosebleeds): Occurring with varying frequency and severity.

Nasal Congestion: Sensation of blocked nostrils. [6]

Nasal Dryness: A troublesome sensation of dryness in the nose, even when breathing freely.

Nasal Polypi: Growths in the nose, usually accompanied by a loss of the sense of smell. These polyps can extend through the nasal passages into the throat (fauces).

Impaired Smell: Impaired or lost sense of smell.

• Distorted sense of smell. [Translator's Note: This can manifest as perceiving unusual smells, such as manure, or other peculiar odors that are not actually present.]
• An overly intense sense of smell, with extreme sensitivity even to faint or imperceptible odors.
• Scabs inside the nose; discharge of pus or hardened mucus clots. [Translator's Note: Sometimes accompanied by a discharge of acrid (irritating) mucus from the nose.]
• A foul or putrid smell perceived within the nose.
• Frequent ulceration of the nostrils, often surrounded by pimples and scabs.
• Frequent or persistent swelling and redness of the nose, particularly the tip.
• Persistent scabs or itchy pimples located under the nose or on the upper lip.
• The red part of the lips appears noticeably pale.
• The red part of the lips is dry, scabby, peeling, and chapped.
• Swelling of the lips, particularly the upper lip. [Translator's Note: This swelling can sometimes be accompanied by a burning, biting pain.]
• The inner surface of the lips is covered with small sores or blisters. [Translator's Note: These are often very painful, appearing and disappearing periodically.]
• Skin eruptions on the beard area and at the roots of beard hairs, accompanied by itching.
• Numerous types of facial eruptions. [Translator's Note: These can include conditions like milk-crust (crusta lactea), pimples, blotches, herpes, and even cancerous ulcers (carcinomatous ulcers) affecting the nose, lips, and face, often associated with burning and stinging pain.]
• Swollen glands in the lower jaw, sometimes progressing to chronic pus formation (suppuration).
• Glandular swellings along the sides of the neck.
• Gums that bleed easily from a slight touch.
• Painful gums, both outer and inner surfaces, feeling as if wounded.
• Gums with an erosive, itching sensation.
• Gums that are whitish, swollen, and painful to the touch.
• Gum recession, exposing the front teeth and their roots.
• Teeth grinding (bruxism) during sleep.
• Loose teeth and various forms of tooth deterioration, even in the absence of pain.
• Countless varieties of toothache, triggered by diverse causes.
• Inability to stay in bed at night due to toothache.
• Painful blisters and sores on the tongue.
• Tongue appearing white, with a white coating or furred appearance.
• Tongue that is pale and bluish-white.
• Tongue marked by deep furrows, appearing torn in places on its surface.
• Dry tongue.
• A sensation of dryness on the tongue, even when it is adequately moist.

Stuttering, stammering; sometimes accompanied by sudden episodes of speechlessness.

Painful blisters or sores on the inside of the cheeks.

Bleeding from the mouth, often severe.

A sensation of dryness throughout the entire mouth, or only in specific spots, or deep in the throat. [1]

Foul odor from the mouth.

Burning sensation in the throat.

Constant flow of saliva, especially when speaking, and particularly in the morning.

Continual spitting of saliva.

Frequent accumulation of mucus deep in the throat (the fauces), requiring frequent hawking and expectoration throughout the day, especially in the morning.

Frequent throat inflammation and swelling of the swallowing apparatus.

Insipid, slimy taste in the mouth.

An intolerably sweet taste in the mouth, almost constant.

A bitter taste in the mouth, mostly in the morning. [2]

A sourish or distinctly sour taste in the mouth, especially after eating, even when the food itself tasted normal. [3]

Putrid and foul taste in the mouth.

Bad breath, sometimes moldy, sometimes putrid like old cheese, or like foul foot sweat, or like rotten sauerkraut.

Eructations (burping) with the taste of food, several hours after eating.

Empty, loud eructations of mere air, uncontrollable, often lasting for hours, not infrequently at night.

Incomplete eructations, causing only convulsive spasms in the fauces, without actually exiting the mouth.

Sour eructations, either when fasting or after food, especially after milk.

Eructations that induce vomiting.

Rancid eructations (especially after eating fatty foods).

Putrid or moldy eructations, early in the morning.

Frequent eructations before meals, accompanied by a kind of ravenous hunger.

Heartburn, occurring with varying frequency; a burning sensation along the chest, especially after breakfast or when moving the body.

Gastrointestinal Symptoms

Water-brash: A sudden, gushing discharge of a watery, salivary fluid from the stomach, often preceded by severe, twisting pains in the stomach (possibly originating from the pancreas). This is accompanied by a sensation of weakness or shakiness, nausea so intense it feels like fainting, and an excessive accumulation of saliva in the mouth, even at night. [1]

The predominant symptoms in any part of the body are triggered after eating fresh fruit, especially if it’s acidic, and also after consuming acetic acid (found in salads, etc.).

Nausea occurring early in the morning. [2]

Nausea, sometimes progressing to vomiting, experienced immediately after waking up in the morning, which lessens with movement.

Nausea consistently occurs after consuming fatty foods or milk.

Vomiting blood (hematemesis).

Hiccups after eating or drinking.

Swallowing is hindered by spasms, potentially leading to starvation.

Spasmodic, involuntary swallowing.

A frequent sensation of fasting and emptiness in the stomach (or abdomen), often accompanied by excessive saliva in the mouth.

Ravenous hunger (also known as canine hunger or bulimia), particularly in the early morning. The individual feels compelled to eat immediately, otherwise becoming faint, exhausted, and shaky (or, if outdoors, needing to lie down flat).

Ravenous hunger accompanied by rumbling and gurgling sounds in the abdomen.

Appetite without true hunger: The individual desires to quickly swallow various items, even without any actual craving or sensation of hunger in the stomach.

A peculiar kind of hunger: However, as soon as the individual eats even a small amount, they immediately feel satiated and full.

When the individual desires to eat, they experience a sensation of fullness in the chest, and their throat feels as if it’s filled with mucus.

Lack of appetite: Only a gnawing, twisting, and writhing sensation in the stomach compels the individual to eat.

Aversion to cooked, warm food, particularly boiled meat. There is hardly any desire for anything other than rye-bread (with butter) or potatoes. [3]

Upon waking in the morning, immediate and constant thirst.

A sensation of swelling in the pit of the stomach, painful to the touch.

A feeling of coldness in the pit of the stomach.

Pressure in the stomach or pit of the stomach, as if from a stone, or a constricting, cramp-like pain. [1]

Beating and pulsation in the stomach, even on an empty stomach.

Stomach spasms; a pain in the pit of the stomach as if it’s being constricted. [2]

Griping pain in the stomach; a sudden, painful constriction of the stomach, especially after drinking cold beverages. [3]

Stomach pain, as if raw or sore, even when eating the mildest foods.

Pressure in the stomach, even on an empty stomach, but worse after any kind of food, or specific dishes like fruit, green vegetables, rye bread, or foods containing vinegar. [4]

During eating, dizziness and giddiness, with a sensation of threatening to fall to one side.

After even the slightest supper, nocturnal heat in bed; followed by morning constipation and extreme lassitude.

After meals, anxiety accompanied by cold perspiration. [5]

Perspiration during eating.

Vomiting immediately after eating.

After meals, pressure and burning in the stomach or epigastrium, similar to heartburn.

After eating, a burning sensation in the esophagus, rising from below upwards.

After meals, abdominal distension. [6]

• After meals, the patient feels very tired and sleepy, often until they lie down and sleep.

• After meals, a feeling of intoxication.

• After meals, a headache.

• After meals, heart palpitations.

• Eating brings relief to various complaints, even those seemingly unrelated.

• Flatus does not pass; instead, it moves around, causing various physical and mental ailments, such as drawing pains in the limbs (especially lower limbs) or sharp, stitching pains in the pit of the stomach or side of the abdomen.

• The abdomen is distended by flatus and feels full, especially after a meal. This flatus often ascends. Sometimes, a large quantity of odorless flatus is passed, especially in the morning, without relieving other symptoms. In other cases, there is significant flatulence with a large quantity of excessively foul-smelling flatus.

• A sensation as if flatus is rising, followed by burping (eructations). This often leads to a burning sensation in the throat or vomiting, day and night.

• Pain in the hypochondria (upper sides of the abdomen) when touched, during movement, or even at rest.

• A constricting pain in the epigastrium (upper central abdomen), immediately below the ribs.

• Sharp, cutting pains in the abdomen, as if from trapped flatus. There is a constant sensation of fullness in the abdomen, and the flatus feels like it is rising upwards.

• Sharp, cutting pains in the abdomen occur almost daily, especially in children. These pains are more common in the morning than at other times of the day, sometimes persisting day and night, without diarrhea.

• Sharp, cutting pains in the abdomen, particularly on one side or in the groin. These pains can sometimes extend down into the rectum and along the thigh.

• In the abdomen, a feeling of nausea (qualmishness), a sensation of voidness or disagreeable emptiness, sometimes alternating with a contractive pain. This can occur even immediately after eating, making the patient feel as if nothing had been consumed.

• A constricting sensation, like a tight bandage, extending from the lower back around the abdomen, especially below the stomach, after several days without a bowel movement.

• Pain in the liver when touching the right side of the abdomen.

• Pain in the liver, accompanied by pressure and tension, specifically a tension below the ribs on the right side.

• Below the last ribs (in the hypochondria), a widespread tension and pressure that restricts breathing and causes anxiety and sadness.

• Stitching pains in the liver, especially when bending quickly.
• Inflammation of the liver.
• Pressure in the abdomen, as if from a stone, often rising to the pit of the stomach, causing a digging sensation and vomiting.
• Hardness of the abdomen.
• Crampy colic, with a grasping pain in the bowels.
• During colic, a sensation of coldness on one side of the abdomen.
• A clucking, croaking, and audible rumbling and grumbling in the abdomen, sometimes only on the left side, moving upwards with inspiration and downwards with expiration.
• Uterine spasms, resembling labor pains, with grasping pains that often compel the patient to lie down. The abdomen frequently distends quickly without flatulence.
• Pains in the lower abdomen pressing down toward the genitals, as if to cause a prolapse. After these pains, the patient feels heavy in all limbs, which go to sleep, compelling them to stretch and extend their limbs.
• Inguinal hernias, often painful while speaking and singing. [Translator’s Note: Hahnemann states that inguinal hernias typically arise from internal Psora, except in cases of severe external injury or superhuman exertion (e.g., lifting/pushing quickly during extreme fright).]
• Swelling of the inguinal glands, sometimes progressing to suppuration.
• Constipation; stools delayed for several days, often accompanied by repeated, ineffectual urges to defecate.
• Stools are hard, as if burnt, appearing in small, knotty pieces resembling sheep-dung. They are often covered with mucus and sometimes enveloped by small blood vessels.
• Stools consisting solely of mucus (mucous piles).
• Passage of round worms from the anus.
• Discharge of pieces of tape-worm.
• Stools are initially very hard and difficult, followed by diarrhea.
• Very pale, whitish stool.
• Gray stools.
• Green stools.
• Clay-colored stools.
• Stools with a putrid, sour smell.
• Cutting pains in the rectum during defecation.
• Diarrhea lasting for several weeks, months, or even years, usually preceded by rumbling or fermentation in the abdomen, chiefly in the morning.
• Frequently repeated diarrhea, accompanied by cutting pains in the abdomen, lasting several days.

After a bowel movement, especially a softer, more abundant one, there is sudden and profound prostration (extreme weakness). This weakness often manifests as a feeling in the pit of the stomach, accompanied by anxiety, restlessness, and sometimes chills in the abdomen or lower back.

Diarrhea that quickly becomes so debilitating that the person cannot walk unassisted.

Painless and painful hemorrhoidal varices (hemorrhoids) on the anus and in the rectum (often referred to as ‘blind piles’). These often ooze a slimy fluid.

Bleeding hemorrhoidal varices (hemorrhoids) on the anus or in the rectum (known as ‘running piles’), especially during bowel movements. Afterward, these hemorrhoids often cause severe pain for an extended period.

Hahnemann notes that Fistula in ano (anal fistula) probably never has any other cause than this malady (Psora), especially when combined with a stimulating diet, excessive alcohol consumption, frequent laxatives, a sedentary lifestyle, and abuse of the sexual instinct.

Along with bloody discharges from the anus or rectum, there’s a sensation of blood rushing through the body (ebullition of blood) and shortness of breath.

Formication (a sensation of insects crawling) and itchy formication in the rectum, with or without the expulsion of ascarides (roundworms).

Itching and erosion (skin breakdown) in the anus and perineum.

Polyps in the rectum.

During urination, anxiety, and sometimes prostration (extreme weakness).

Sometimes an excessive amount of urine is passed, followed by profound fatigue. Hahnemann suggests that Diabetes, which is usually so fatal with Allopathic remedies, probably never has any other origin than this malady (Psora).

Painful retention of urine (difficulty emptying the bladder, especially in children and the elderly).

When chilled (feeling cold throughout the body), the person is unable to urinate.

Sometimes, due to flatulence, the person cannot urinate.

The urethra is constricted in certain areas, particularly in the morning. The urine stream may be as thin as a thread or spread out; urination occurs only in jerks at long intervals. These interruptions are often caused by a spasm in the bladder neck, which opposes bladder function and originates from the same Psora malady. Similarly, bladder inflammation resulting from urethral strictures and fistula in vesica (bladder fistula) are always of psoric origin, although in rare cases, Sycosis may complicate Psora.

Symptoms Related to Urinary and Genital Systems

• After urination, urine continues to drip for a prolonged period.
• Whitish urine, with a sweetish smell and taste, is passed in excessive abundance, accompanied by prostration, emaciation, and unquenchable thirst (diabetes).
• During urination, there is burning, as well as sharp, shooting (lancinating) pains in the urethra and the bladder neck.
• Urine with a penetrating, sharp odor.
• The urine quickly forms a sediment.
• The urine discharged is immediately turbid, resembling whey.
• From time to time, red sand (kidney grits) is discharged with the urine.
• Dark-yellow urine.
• Brown urine.
• Blackish urine.
• Urine containing blood particles, and sometimes complete hematuria.
• Discharge of prostatic fluid after urination, but especially after a difficult bowel movement. This can also manifest as an almost constant dripping of the fluid.
  • [Translator’s Note: Hahnemann notes that this constant oozing of prostatic fluid can sometimes lead to ‘consumption’ (a historical term often referring to wasting diseases, like tuberculosis, or general debility).]
• Nocturnal emissions (wet dreams) that are too frequent: one, two, or three times a week, or even every night.
  • [Translator’s Note: Hahnemann contrasts this with healthy, chaste young men, for whom nocturnal emissions naturally occur only every twelve or fourteen days, without any associated problems, and are followed by cheerfulness, a feeling of strength, and serenity.]
• Nightly discharge of genital fluid in women, accompanied by voluptuous dreams.
• Nocturnal emissions (pollutions), even if not frequent, are immediately followed by detrimental consequences.
  • [Translator’s Note: These detrimental consequences include gloominess, mental dullness, impaired thinking abilities, diminished imagination, memory loss, depression, and melancholy. Additionally, vision, digestion, and appetite are weakened; stools are retained, and there’s a rush of blood to the head and anus, among other symptoms.]
• Semen passes almost involuntarily during the daytime, with minimal excitation, often even without an erection.
• Erections are very frequent, prolonged, and very painful, even without emissions.
• Semen is not discharged even during prolonged coition with a proper erection. Instead, it passes off afterward as nocturnal emissions or with the urine.
  • [Translator’s Note: In such cases, the testicles never retract towards the body but hang down more loosely.]
• Accumulation of fluid in the tunica vaginalis of the testicle (hydrocele).
• There is never a complete erection, even with the most intense voluptuous excitement.

• Painful muscle twitches in the penis.
• Itching of the scrotum, sometimes covered with pimples and scabs.
• Chronic swelling of one or both testicles, or a knotty infection (Sarcocele).
• Shrinking or disappearance of one or both testicles.
• Hardening and enlargement of the prostate gland.
• Tugging pain in the testicle and spermatic cord.
• Bruising pain in the testicle.
• Frequent or constant loss of sexual desire in both sexes.
  • [Explanation for the above symptom:] This lack of desire often persists for years, even many years. In males, the penis cannot be aroused to any pleasurable sensation; it hangs relaxed, appearing thinner than the glans, which feels cold and has a bluish or white color. In females, the labia are not excitable, appearing relaxed and small; the vagina is almost numb, insensible, and usually dry. Sometimes, there is hair loss from the pubic area (pudenda), or complete bareness of the female genital parts.
• Uncontrollable, insatiable lust, accompanied by a wasted (cachectic) complexion and a sickly body.
  • [Explanation for the above symptom:] Conditions like Metromania and Nymphomania stem from the same underlying cause.
• Sterility or impotence, without any initial organic defect in the sexual organs.
  • [Explanation for the above symptom:] Frequent coition driven by impotent lust, characterized by the premature ejaculation of immature, watery semen, or an inability to achieve erection, or absence of semen emission, or a complete lack of sexual desire. In females, symptoms include excessively heavy menses, or a constant flow of watery blood, or scanty/deficient menses; copious vaginal discharge (leucorrhea); hardened ovaries; breasts that have either shrunk or become lumpy; and either insensitivity or merely painful sensitivity of the genital organs. These are merely the immediate, common symptoms of sterility or impotence in either sex.
• Menstrual irregularities: The menses do not appear regularly every twenty-eighth day after their last occurrence. They are not free from other ailments, do not start abruptly, and do not continue steadily for three or four days with a moderate quantity of healthy-colored, mild blood, gradually ending on the fourth day without disturbing the overall physical and mental health. Furthermore, menstruation does not continue until the forty-eighth or fiftieth year, nor does it cease gradually and without any associated problems.
• Menses are delayed, appearing slowly after the fifteenth year or later. Alternatively, after one or more occurrences, they cease for several months or even years.
  • [Explanation for the above symptom:] This is often accompanied by a sallow paleness and swelling of the face, heaviness in the limbs, swollen feet, chilliness, weariness, and asthma-like symptoms (chlorosis), among others.
• Menses do not maintain regular periods; they may come several days too early, sometimes every three weeks, or even every fortnight.
  • [Explanation for the above symptom:] It is rare for menses to come several days too late; when they do, the flow is usually excessively heavy, accompanied by debilitating weariness and many other ailments.

• Menstrual flow lasts only one day, a few hours, or in barely perceptible amounts.
• Menstrual flow lasts five, six, eight, or even more days, but it is intermittent. A small amount flows every six, twelve, or twenty-four hours, then stops for half or full days before more is discharged.
• Menstrual flow is excessively heavy, lasting for weeks, or returns almost daily (a condition known as bloody flux). [1]
• Menstrual blood is watery or consists of brown clots.
• Menstrual blood has a very foul odor.
• Menstruation is accompanied by numerous ailments, such as fainting spells, headaches (often stitching pains), or contractive, spasmodic, cutting pains in the abdomen and lower back. The patient is often compelled to lie down, vomits, and experiences other symptoms.
• Polypi in the vagina.
• Leucorrhœa (vaginal discharge) occurs from the vagina, either one or several days before, or soon after, the monthly blood flow. It can also persist throughout the entire period between one menstrual discharge and the next, sometimes with reduced menstrual flow, or even continuing solely in place of menstruation. The discharge can be like milk, white or yellow mucus, or like acrid, and sometimes foul-smelling, water. [2]
• Premature births.

Clinical Manifestations

During pregnancy, women experience extreme fatigue, nausea, frequent vomiting, fainting spells (swoons), painful varicose veins on the thighs, legs, and sometimes even on the labia, along with various hysterical ailments.

Immediate runny nose (coryza) upon entering the open air, which then typically becomes a stuffy nose (stuffed coryza) indoors.

Frequent or almost constant dry coryza and a stuffy nose, sometimes with brief periods of relief.

Profuse runny nose (fluent coryza) triggered by the slightest exposure to cold, especially during harsh, wet weather.

Very frequent or almost constant profuse runny nose (fluent coryza), sometimes without any interruption.

Despite strong warning signs of a cold, the patient cannot catch one, even while suffering from other significant symptoms of the itch malady.

Hoarseness after minimal speaking; the patient feels compelled to vomit to clear their voice.

Hoarseness, sometimes progressing to aphony (inability to speak loudly, requiring whispering), after a minor cold.

Persistent hoarseness and aphony lasting for years; the patient cannot utter a loud word.

Pus formation (suppuration) in the larynx and bronchi (laryngo-bronchial phthisis). [1]

Very frequent or almost constant hoarseness and catarrh; the chest is perpetually affected.

Cough, accompanied by frequent irritation and a crawling sensation in the throat; the cough is tormenting until sweat appears on the face (and hands).

Cough that only subsides after retching and vomiting, typically in the morning or evening.

Cough that consistently ends with sneezing.

Cough, predominantly in the evening after lying down and whenever the head is in a low position.

Cough that awakens the patient after the initial short period of sleep.

Cough, particularly at night.

Cough, most severe after waking in the morning.

Cough, most severe after eating.

Immediate cough with every deep breath.

Cough that causes a sensation of soreness in the chest, or sometimes sharp, stitching pains in the side of the chest or abdomen.

Dry cough.

Chest and Respiratory Symptoms

• Cough, with pus-like yellow expectoration, sometimes accompanied by spitting of blood. [1]
• Cough, with excessive mucus expectoration and significant loss of strength (mucous phthisis).
• Attacks of whooping cough. [2]
• Violent, sometimes unbearable, stabbing pains in the chest with every breath; coughing is impossible due to the pain; occurs without inflammatory fever (spurious pleurisy).
• Chest pain upon walking, feeling as if the chest is about to burst.
• Pressing pain in the chest, especially during deep breathing or sneezing.
• Often a slightly constricting pain in the chest, which, if it doesn’t quickly subside, leads to profound despair. [3]
• Burning pain in the chest.
• Frequent stabbing pains in the chest, with or without cough.
• Violent stabbing pains in the side; accompanied by intense body heat, making breathing almost impossible due to chest pains, hemoptysis, and headache; the patient is confined to bed.
• Nightmare; the patient typically awakens suddenly at night from a terrifying dream but cannot move, call out, or speak. When attempting to move, they experience intolerable pains, as if being torn apart. [4]
• Obstructed breathing, with stabbing pains in the chest upon the slightest exertion of walking; the patient cannot take another step (angina pectoris). [5]
• Asthma, triggered merely by moving the arms, but not by walking.
• Attacks of suffocation, especially after midnight; the patient must sit up, sometimes even leave bed, stand stooping forward, leaning on their hands. They need to open windows or go into the open air, etc. Palpitations occur, followed by eructations or yawning, and the spasm ends, with or without coughing and expectoration.

• Heart palpitations accompanied by anxiety, particularly at night.
• Asthma characterized by loud, difficult, and sometimes wheezing (sibilant) respiration.
• Shortness of breath.
• Asthma triggered by movement, with or without an accompanying cough.
• Asthma predominantly experienced while sitting.
• Spasmodic asthma; the patient experiences breathlessness upon entering the open air.
• Asthma occurring in attacks that last for several weeks.
• Atrophy (dwindling) of the breasts, or their excessive enlargement, accompanied by retracted nipples.
• Erysipelas (a skin infection) on one of the breasts, particularly during nursing.
• A hard, enlarging, and indurated gland in one of the breasts, accompanied by sharp, shooting (lancinating) pains. [1]
• Itching, moist, and scaly eruptions around the nipples.
• Drawing (tearing) and tensive pains in the lower back, general back region, and nape of the neck.
• Sharp, cutting, and painfully stiff sensation in the nape of the neck and lower back.
• Pressing pain between the shoulder blades.
• Sensation of pressure on the shoulders.
• Drawing (tearing) and tensive pains in the limbs, affecting both muscles and joints (rheumatism).
• Pressing and pressing-drawing pains in the periosteum (the membrane covering bones), occurring sporadically, especially in the periosteum of long bones. [2]
• Stitching pains in the fingers or toes. [3]
• Stitching pains in the heels and soles of the feet when standing.
• Burning sensation in the soles of the feet. [4]
• In the joints, a tearing sensation, like scraping on the bone, accompanied by red, hot swelling that is painfully sensitive to touch and to air. This is associated with an unbearably sensitive and peevish disposition (characteristic of gout, including podagra (gout in the foot), chiragra (gout in the hand), gout in the knees, etc.). [5]
• Swollen finger joints with pressing pains, painful upon touching and bending.

Joint and Bone Symptoms

Joints become thick and remain hard and swollen, causing pain when bent.

Joints feel stiff, with painful, difficult motion, as if the ligaments are too short. This can manifest as stiffness in the Achilles tendon (tendo Achillis) when standing erect, or stiffness in the ankle (tarsus) and knees, which can be temporary (e.g., after sitting, when rising) or permanent (contraction).

Joints are painful during movement. For instance, the shoulder joint hurts when raising the arm, or the ankle (tarsus) pains when stepping (treading) as if it’s about to break.

Joints crack or make a snapping noise when moved.

Joints are easily sprained or strained, such as the ankle (tarsus), wrist joint, or thumb joint.

There’s an increasing tendency to strains and to ‘overlift’ oneself, even with very slight muscular exertion. This can happen during minor physical tasks, reaching or stretching for something high up, lifting light objects, quick body turns, pushing, etc. Such muscle tension or stretching often leads to prolonged bed rest, fainting spells (swoons), various degrees of hysterical troubles, fever, hæmoptysis, etc. In contrast, non-Psora individuals can lift burdens within their muscular capacity without any adverse after-effects. [Translator’s Note: The ‘hysterical troubles’ mentioned can include severe headache in the crown of the head (which is also painful externally when touched), sudden pain in the lower back, uterine pain, frequent sharp pains (stitches) in the side of the chest or between the shoulder blades that hinder breathing, painful stiffness of the neck or spine, frequent audible burping (eructations), and more. Regarding the tendency to ‘overlift,’ common people, especially in rural areas, often seek temporary relief through a form of ‘mesmeric stroking’ (massage), typically performed by a woman (a ‘stroking woman’). She uses her thumbs to make passes over the shoulder blades towards the shoulders or along the spine, sometimes from the pit of the stomach below the ribs. However, this often involves excessive pressure and provides no lasting effects; the underlying tendency to ‘overlift’ remains.]

Joints are easily sprained with any awkward movement. For example, the ankle can be sprained with a false step, or the shoulder joint. This also includes the gradual dislocation (luxation) of the hip joint (i.e., the head of the femur separating from the acetabulum), which can cause the leg to become too long or too short, leading to limping.

Softening of the bones, curvature of the spine (leading to deformity or hunchback), and curvature of the long bones of the thighs and legs (known as morbus anglicus or rickets).

Bones are fragile.

The skin, muscles, and periosteum are painfully sensitive to even moderate pressure. For instance, if the person moderately bumps against something, it becomes very painful for a long time. Parts of the body on which they lie in bed become very painful, causing them to turn over frequently at night. The posterior muscles of the thigh and the bone on which they sit become quite sore. Even a slight stroke with the hand on the thighs causes great pain. A slight knock against a hard object leaves blue marks and blood suffusion.

• Intense, Paradoxical Pains: The patient experiences incredibly varied and often indescribable pains—burning, jerking, or lancinating—in the skin, muscles, or periosteum of a body part. These pains are triggered by even a slight movement of that part or a distant one. For example, writing might cause pain in the shoulder or neck, yet sawing or other strenuous labor with the same hand causes no pain. Similarly, speaking or moving the mouth can cause pain in adjacent areas, and a light touch can provoke pain in the lips or back. These pains often affect the upper body, face (like tic douloureux), or neck skin, making even gentle touch, speaking, or chewing intolerable. A slight pressure or finger movement can cause shoulder pain. [Translator’s Note: These severe pains often impart a similar, intolerable hypersensitivity to the mind.]

• Numbness and Insensitivity: Numbness affects the skin or muscles of specific parts and limbs. The sense of touch is lost, and the affected areas feel hard and swollen, either intermittently or constantly.

• “Dying Off” of Extremities: Certain fingers, hands, or feet experience a sensation of “dying off.” The affected limb becomes white, bloodless, completely cold, and loses all sensation, often for hours, especially in cool conditions. [Translator’s Note: Hahnemann mentions a palliative treatment: stroking the affected fingers or toes with a piece of zinc towards the tips usually provides quick, though temporary, relief.]

• Crawling and Prickling Sensations (Formication): A crawling or prickling sensation, similar to a limb “falling asleep,” occurs in the arms, legs, and other parts, including the fingertips.

• Restless Limbs: A crawling, whirling, or internally itching restlessness, particularly in the lower limbs, is experienced, especially in the evening in bed or upon waking. The patient feels compelled to constantly change their position.

• Painful Coldness: A painful sensation of cold is felt in various parts of the body.

• Burning Pains: Burning pains occur in different areas, often without any noticeable change in the body’s external temperature.

• Persistent Coldness: The entire body, or one side of it, experiences repeated or constant coldness. This also applies to individual parts, such as cold hands and feet that frequently remain cold even in bed.

• Constant Chilliness: A persistent feeling of chilliness is present, even when there is no change in the external body temperature.

• Frequent Hot Flushes: Frequent flushes of heat occur, especially in the face, often accompanied by redness. There are sudden, intense sensations of heat during rest or slight movement, sometimes even from speaking, with or without breaking out in perspiration.

• Aversion to Warm Air: Warm air in a room or public place (like a church) is extremely disagreeable, causing restlessness and a need to move about. This can sometimes be accompanied by a pressure in the head, over the eyes, which is not infrequently relieved by a nosebleed (epistaxis).

Sudden rushes of blood, sometimes accompanied by a throbbing sensation in all arteries (even when the person appears quite pale and feels utterly exhausted throughout the body).

Rushes of blood to the head.

Rushes of blood to the chest.

Varices (varicose veins) in the lower limbs, including the external genitalia (pudenda), and sometimes even on the arms (even in men). These often cause tearing pains (especially during storms) or intense itching. [1]

Erysipelas, appearing on the face (with fever), on the limbs, or on the breast during nursing, particularly in an already sore area (accompanied by a prickling and burning pain).

Whitlow or paronychia (a painful, festering infection of the finger, often around the nail).

Chilblains on the toes and fingers (occurring even outside of winter), causing itching, burning, and sharp, lancinating pains.

Corns that cause burning, lancinating pains even without external pressure.

Boils (furuncles) that recur periodically, especially on the buttocks, thighs, upper arms, and torso. Touching them elicits sharp, fine stinging pains.

Ulcers, particularly on the thighs, ankles, above the ankles, and on the lower calves. These ulcers are characterized by itching, gnawing, and tickling sensations around their edges, and a gnawing pain at their base, as if salt were applied. The surrounding skin appears brown and bluish. Varices are often present near these ulcers, causing tearing pains, especially at night during storms and rains. These ulcers can also be accompanied by Erysipelas following distress or fright, or by cramps in the calves.

Swelling (tumefaction) and pus formation (suppuration) in bones such as the humerus, femur, patella, and also the bones of the fingers and toes (a condition known as spina ventosa).

Thickening and stiffening of the joints.

Skin eruptions that appear periodically and then subside. These include:

• Voluptuously itching pustules, especially on the fingers or other body parts, which burn intensely after scratching and closely resemble the original itch-eruption.
• Nettle-rash, resembling stings and water-blisters, usually accompanied by burning pain.
• Pimples without pain on the face, chest, back, arms, and thighs.
• Herpes appearing as fine, miliary grains, tightly clustered into round spots of varying sizes, mostly reddish. These can be dry or moist, cause itching (similar to an itch eruption), and burn after rubbing. They continuously spread outwards with redness, while the center appears to clear, becoming covered with smooth, shiny skin (herpes circinatus). When moist herpes appears on the legs, it is referred to as salt-rheum.
• Round crusts, raised above the surrounding skin, with deep-red, painless borders. There are often frequent, violent stinging pains in the unaffected skin nearby.
• Small, round spots on the skin covered with dry, bran-like scales that frequently peel off and renew without any sensation.
• Red, dry-feeling skin spots, somewhat raised above the surrounding skin, accompanied by burning pain.

Skin Manifestations and Glandular Issues

• Freckles: Small, round, brown or brownish spots appearing on the face, hands, and chest, without any sensation.
• Liver Spots: Large brownish spots that often cover entire limbs, such as the arms, neck, or chest. These may be without sensation or accompanied by itching.
• Yellowish Skin Discoloration: Yellow spots of a similar nature appearing around the eyes, mouth, or on the neck, without any sensitivity. This yellowness can appear quite rapidly after activities like carriage riding, especially when it’s not yet a constant condition but only occasional.
• Warts: Occurring on the face, forearms, hands, and other areas. These are particularly common in youth. Many warts only last a short time before disappearing, making way for another symptom of Psora.
• Encysted Tumors: These can be found in the skin, the cellular tissue beneath it, or within the mucous bursae (bursae mucosæ) of tendons (sometimes resembling exostosis). They vary in form and size, feel cold, and lack sensation. [Translator’s Note: Hahnemann here refers to fungus hematodes (a bloody, fungating tumor, often malignant) as having its sole origin in Psora, based on his observations.]
• Glandular Swellings: Occurring around the neck, in the groin, in the bends of joints (like the elbow and knee), and in the armpits (axillae), as well as in the breasts. Sometimes, after sharp, shooting (lancinating) pains, these swellings develop into a form of chronic suppuration. However, instead of pus, they secrete only a colorless mucus.
• Dry Skin: The outer layer of skin (epidermis) can be dry either across the entire body, accompanied by an inability to perspire even with movement and heat, or only in specific areas. This dryness is especially noticeable on the hands, the outer sides of the arms and legs, and even the face. The skin feels dry, rough, parched, chapped, and often has bran-like scales.

Unpleasant sensation of dryness over the entire body (also in the face, around and inside the mouth, in the throat, or in the nose, even though breathing passes freely through it).

Sweating occurs too easily with slight exertion; even while sitting, the patient breaks out in a sweat all over, or merely on some parts; for example, almost constant perspiration of the hands and feet, [1] and also, profuse sweating in the axillae (armpits) [2] and around the pudenda (genitals).

Daily morning sweats, often making the patient drip with sweat, persisting for many years, often with a sour or acrid-sour odor. [3]

Unilateral sweating, only on one side of the body, or only on the upper part of the body, or only on the lower part.

Increased susceptibility to colds, affecting either the entire body (often even from repeatedly wetting the hands, first with warm water, then with cold, as when washing clothes), or affecting only specific body parts like the head, neck, chest, abdomen, feet, etc., often from a moderate or slight draft, or after slightly moistening these areas; [4] even from being in a cooler room, in a rainy atmosphere, or with a low barometer.

So-called “weather prophets”; meaning, recurrent severe pains in body parts that were previously injured, wounded, or fractured, even though they have since healed and cicatrized; this renewed pain appears when significant weather changes, intense cold, or a storm are imminent, or when a thunderstorm is approaching.

Edematous swelling, either affecting only the feet, or one foot, or the hands, face, abdomen, or scrotum, etc., or generalized cutaneous swelling over the entire body (dropsy).

Sudden attacks of heaviness in the arms or legs.

Attacks of paralytic weakness and lassitude affecting one arm, one hand, or one leg, without pain; either appearing suddenly and resolving quickly, or beginning gradually and steadily worsening.

Sudden buckling of the knees.

Children fall easily without any apparent reason. Adults experience similar episodes of leg weakness, causing them to stumble or walk unsteadily, with one foot dragging or veering off.

While walking outdoors, sudden attacks of faintness occur, particularly affecting the legs. [1]

While sitting, the patient feels an unbearable weariness, yet feels stronger when walking.

There’s an increased tendency to sprain or strain joints from a misstep or an awkward movement, sometimes even leading to dislocation (e.g., in the ankle or shoulder joint).

Joints snap and crack with any limb movement, accompanied by an unpleasant sensation.

Limbs ‘go to sleep’ (numbness/tingling) more frequently and are triggered by minor causes; for example, resting the head on an arm or crossing the legs while sitting.

Painful muscle cramps become more frequent and occur without any apparent cause.

Slow, spasmodic contractions (straining) of the limb’s flexor muscles.

Sudden jerks or twitches occur in various muscles and limbs, even while awake; for instance, in the tongue, lips, facial muscles, pharynx, eyes, jaws, hands, and feet.

Tonic shortening of the flexor muscles (a condition resembling tetanus).

Involuntary turning and twisting of the head or limbs, occurring with full consciousness (known historically as St. Vitus’ dance). [Translator’s Note: St. Vitus’ dance is an older term for Sydenham’s chorea, a neurological disorder characterized by rapid, involuntary, purposeless movements.]

Sudden fainting spells and a profound loss of strength, accompanied by loss of consciousness.

Episodes of limb tremor occur without accompanying anxiety. This can manifest as continuous, constant trembling, and in some cases, a beating or flapping motion of the hands, arms, or legs.

Episodes of loss of consciousness, lasting a moment or a minute, often accompanied by the head inclining to one shoulder, with or without jerking movements in other body parts.

Various types of epileptic seizures.

Almost constant yawning, stretching, and straining of the limbs.

Daytime sleepiness, often occurring immediately after sitting down, particularly after meals.

Difficulty falling asleep in the evening; the patient often lies awake for hours.

He experiences only a light, superficial sleep at night.

Every night, he suffers from sleeplessness due to anxious heat, an anxiety that sometimes becomes so intense he has to get out of bed and walk around.

After three o’clock in the morning, he cannot sleep, or at least cannot achieve sound sleep.

The moment he closes his eyes, he sees all sorts of bizarre images and distorted faces.

As she tries to fall asleep, she is disturbed by strange, anxious thoughts; she has to get up and walk around.

He experiences very vivid dreams, almost as if he were awake; or dreams that are sad, frightening, anxious, vexing, or lascivious.

During sleep, he talks loudly or screams.

Somnambulism (sleepwalking); he gets up at night, while still asleep with closed eyes, and performs various tasks; he can even carry out dangerous actions with ease, without any recollection of them when he wakes up.

He experiences attacks of suffocation while sleeping (nightmare).

He suffers from various kinds of severe pains at night, or experiences nocturnal thirst, dryness of the throat and mouth, or frequent urination at night.

Upon waking early, he feels dizzy, sluggish, and unrested, as if he hasn’t slept enough and is more tired than he was the previous evening when he went to bed; it takes him several hours (and only after getting up) to recover from this exhaustion.

Surprisingly, after a very restless night, he often feels stronger in the morning than he does after a quiet, sound sleep.

He experiences intermittent fever, even when there are no other cases around, whether sporadic, epidemic, [1] or endemic. The fever’s form, duration, and type vary greatly: it can be quotidian (daily), tertian (every other day), quartan (every third day), quintan (every fourth day), or occur every seven days.

Every evening, he experiences chills accompanied by blue nails.

Every evening, he experiences isolated chills.

Every evening, he feels heat, accompanied by a rush of blood to the head, red cheeks, and sometimes an intervening chill.

He suffers from intermittent fever lasting several weeks, followed by a moist, itching eruption that also lasts several weeks. This eruption then heals during another similar period of intermittent fever, and this pattern of alternating fever and eruption continues for years.

All sorts of disturbances affecting the mind and spirit. [2]

• Melancholy: Occurs by itself, or combined with insanity, sometimes alternating with periods of frenzy and moments of clarity.
• Anxious oppression: Experienced early upon waking.
• Anxious oppression: Occurs in the evening after going to bed. [1]
• Anxiety: Manifests several times a day (with or without physical pains), or at specific hours of the day or night. Typically, the patient finds no rest, feeling compelled to pace restlessly, and often breaks into a sweat.
• Nighttime awakenings: Melancholy, palpitations, and anxiety cause the patient to wake up from sleep at night (mostly just before the onset of menses).
• Mania of self-destruction (spleen ?). [2]
• Weeping mood: Patients often weep for hours without understanding the cause. [3]
• Attacks of fear: For example, fear of fire, fear of being alone, fear of apoplexy, fear of becoming insane, etc.

• Sudden outbursts of intense emotion, almost like a frenzy.
• Easily startled by the slightest things, often leading to sweating and trembling.
• A strong aversion to work, even in individuals who are usually very industrious; they feel no urge to engage in tasks, but rather a profound reluctance. [1]
• Extreme sensitivity. [2]
• Irritability stemming from weakness. [2]
• Rapid mood swings; often very cheerful and exuberant, then suddenly, and quite abruptly, sinking into dejection—for instance, due to their illness or other trivial reasons. A sudden shift from cheerfulness to sadness, or unexplained vexation.

These are some of the primary symptoms I’ve observed. When they recur frequently or become constant, they indicate that the internal Psora is emerging from its latent state. These symptoms are also the building blocks from which (under unfavorable external conditions) the itch-malady, in its various manifestations, gives rise to an immeasurable number of chronic diseases. It takes on different forms in different individuals, shaped by their bodily constitution, educational shortcomings, habits, occupation, external circumstances, and further modified by various psychological and physical impressions. Thus, it unfolds into countless forms of disease, with so many variations that they are by no means fully described by the symptoms listed in the old school’s pathology, where they are mistakenly labeled as well-defined, constant, and distinct diseases. [*]

[*] They bear the following names: Scrofula, rickets, spina ventosa, atrophy, marasmus, consumption, pulmonary consumption, asthma, tabes mucosa, laryngeal phthisis, chronic catarrh, constant coryza, difficult dentition, worms and consequent diseases, dyspepsia, abdominal cramps, hypochondria, hysteria, dropsy, dropsy of the abdomen, dropsy of the ovaries, of the uterus, hydrocele, hydrocephalus, amenorrhea, dysmenorrhea, uterine hemorrhages, hematemesis, hemoptysis and hemorrhages, vaginal hemorrhages, dysuria, ischuria, enuresis, diabetes, catarrh of the bladder, hematuria, nephralgia, gravel of the kidneys, stricture of the urethra, stricture of the intestines, blind and running piles, fistula of the rectum, difficult stools, constipation, chronic diarrhea, induration of the liver, jaundice, cyanosis, heart diseases, palpitation, spasms of the chest, dropsy of the chest, abortion, sterility, metromania, impotence, induration of the testicles, dwindling of the testicles, prolapsus uteri, inversion of the womb, inguinal, femoral and umbilical hernias, dislocations of the joints from an internal cause, curvature of the spine, chronic inflammations of the eyes, fistula lachrymalis, short-sightedness and long-sightedness, day blindness and night blindness, obscuration of the cornea, cataracts, glaucoma, amaurosis, deafness, deficient smell or taste, chronic one-sided headache, megrim, tic douloureux, tinea capitis, scab, crusta lactea, tetters (herpes), pimples, nettle-rash, encysted tumors, goitre, varices, aneurism, erysipelas, sarcomas, osteosarcoma, scirrhus, cancer of the lips, cheeks, breast, uterus, fungus nematodes, rheumatism, gout in the hips, knotty gout, podagra, apoplectic fits, swoons, vertigo, paralysis, contractions, tetanus, convulsions, epilepsy, St. Vitus’ dance, melancholy, insanity, imbecility, nervous debility, etc.

These are the characteristic secondary symptoms [*] of the long-unacknowledged, thousand-headed monster, teeming with diseases, the Psora – the original miasmatic malady which now makes its manifest appearance. [**]

[*] The Chief Royal Counselor Kopp, an Allopath who reluctantly and only partially embraces Homœopathy, claims to have seen chronic diseases resolve on their own. He may have seen some particular symptoms disappear, which symptoms the old school, in its myopic view, mistakenly regarded, along with him, as complete diseases in themselves!

[**] I concede that the doctrine—that all chronic non-venereal diseases which cannot be overcome by the vital force, even with a healthy lifestyle and favorable external conditions, and which worsen over the years, are of Psora origin—is, for all who have not fully weighed my reasons and for all narrow-minded people, too vast and too profound. But it is nonetheless true. Or should we consider such a chronic disease as not being psoric simply because the patient cannot recall, going all the way back to their birth, ever having several or more intensely (and almost pleasurably) itching pustules of Psora on their skin, or because (since Psora, or ‘itch disease,’ is often considered shameful) they are unwilling to acknowledge it? Their denial here proves nothing to the contrary.

Since all the innumerable chronic diseases resulting from an acknowledged preceding Psora (when it has not been cured) are at all times ineradicable by the vital force, and progress steadily as psoric ailments, continuously worsening: as long as the doubters of the Psora doctrine cannot show me any other source that is at least as probable for a non-venereal ailment—one which, despite favorable external conditions, correct diet, sound moral conduct, and a vigorous bodily constitution, nevertheless increases every year, without any preceding infection from Psora as far as memory goes—then I have on my side an overwhelming analogous probability, a ratio of 100 to 1. This suggests that individual cases of chronic disease showing a similar progression are probably, indeed, must also be of a Psora nature, even if the patient cannot or will not remember a preceding infection.

It’s easy to doubt things we can’t see with our own eyes, but this doubt, in itself, proves nothing. As per the old rule of logic: negantis est probare (the burden of proof is on the one who denies).

To prove the Psora-related nature of these chronic diseases without an obvious infection, we don’t even need the fact that anti-psoric remedies are effective in these cases; this merely serves as confirmation, like checking a correctly solved mathematical problem.

Furthermore, other remedies, even when chosen based on symptom similarity, don’t provide nearly as lasting and complete a cure for these chronic diseases as the recognized anti-psoric ones. This is because anti-psoric remedies, when selected in a Homeopathic manner, are more capable than others of addressing the vast and endless array of symptoms of the great Psora malady. Given this, I don’t understand why people would deny the title of ’especially anti-psoric remedies’ to these specific treatments, unless it’s due to pure dogmatism.

Similarly, there’s no good reason to contradict my explanation (Organon, §73) that acute diseases which recur periodically – for example, inflammations of the throat, chest, etc. – are flare-ups of a latent Psora. This contradiction often arises simply because their inflammatory state, as some argue, is primarily treated with anti-phlogistic remedies (like Aconite, Belladonna, Mercury, and similar drugs), which are not anti-psoric. Nevertheless, these acute conditions originate from a latent Psora, because their habitual recurrence can only be prevented by a definitive cure with anti-psoric remedies.

Cure of the Chronic Diseases

CURE

We now turn to the medical Homoeopathic treatment of the immense number of chronic diseases. While the understanding we’ve gained about their threefold nature certainly hasn’t made treatment easy, it has finally made possible what was previously impossible without this knowledge, as the Homoeopathically specific remedies for each of these three different miasmata have largely been discovered.

We will first address the first two miasmata—the venereal chancre disease (Syphilis) and the figwart disease (Sycosis), along with their sequelae—which account for a significantly smaller portion of chronic diseases. This approach will clear the way for us to discuss the therapeutics of the vastly greater number of diverse chronic diseases that originate from Psora.

SYCOSIS

First, let’s discuss Sycosis, as it is the miasma that has caused by far the fewest chronic diseases and has only been prevalent from time to time. This figwart-disease, which became widespread in later times, especially during the French war from 1809-1814, but has since become increasingly rare, was almost always treated inefficiently and harmfully. Internally, mercury was used because it was considered similar to the venereal chancre-disease. However, Allopathic physicians always treated the growths on the genitals in the most violent external ways: by cauterizing, burning, cutting, or ligatures.

These growths usually first appear on the genitals, often, but not always, accompanied by a type of gonorrhea from the urethra. This occurs several days or several weeks, even many weeks, after infection through sexual intercourse. More rarely, they appear dry and wart-like; more frequently, they are soft, spongy, emitting a distinctively fetid fluid (sweetish and almost like herring-brine), bleed easily, and resemble a coxcomb or a cauliflower (Brassica botrytes). In males, these sprout forth on the glans and on or below the prepuce. In women, they appear on the areas surrounding the pudenda, and the pudenda themselves, which become swollen, are often covered by a great number of them.

When these growths are violently removed, the immediate consequence is that they usually reappear, only to be subjected again, in vain, to a similar, painful, and cruel treatment. But even if they could be eradicated this way, it would merely result in the figwart-disease, having been deprived of the local symptom that acts as a substitute for the internal ailment, manifesting in other, much worse secondary ailments. This is because the Sycosis miasm, present throughout the entire organism, is in no way diminished either by the external destruction of these growths or by the internally administered mercury, which is entirely inappropriate for Sycosis.

Furthermore, mercury, especially when given in very large doses and in the most active preparations, only causes harm in this disease and undermines general health. As a result, similar growths then break out in other parts of the body. These can be whitish, spongy, sensitive, flat elevations in the mouth cavity (on the tongue, palate, and lips), or large, raised, brown, and dry tubercles in the armpits, on the neck, or on the scalp, etc. Other bodily ailments may also arise, of which I will only mention the contraction of the flexor tendons, especially those of the fingers.

[*] Usually, in this kind of gonorrhea, the discharge is thickish, like pus, from the beginning. Urination is less difficult, but the body of the penis is somewhat hard and swollen. In some cases, the penis is also covered on the back with glandular tubercles and is very painful to the touch.

[**] The miasm of other common gonorrheas seems not to penetrate the entire organism, but only to locally stimulate the urinary organs. These yield either to a dose of one drop of fresh parsley-juice, when indicated by a frequent urgency to urinate, or a small dose of Cannabis, Cantharides, or Copaiva balm, according to their different constitution and accompanying ailments. These remedies should, however, always be used in higher dynamizations (potencies), unless a dormant Psora in the patient’s body has been activated by a harsh, irritating, or debilitating Allopathic treatment. In such cases, secondary gonorrheas often persist, which can only be cured by an anti-Psora treatment.

Gonorrhea caused by the fig-wart miasma, along with the aforementioned excrescences (that is, the entire Sycosis), are most reliably and thoroughly cured by the internal use of Thuja [*]. In this case, Thuja is Homeopathic, given in a dose of a few poppy-seed-sized pellets moistened with the dilution potentized to the decillionth degree [**]. After these pellets have completed their action—which may take fifteen, twenty, thirty, or forty days—they should be alternated with an equally small dose of nitric acid, diluted to the decillionth degree. This dose must also be allowed to act for a similar duration to completely remove the gonorrhea and the excrescences, meaning the entire Sycosis.

No external application is necessary, except in the most stubborn and difficult cases. In such instances, the larger fig-warts may be moistened daily with the mild, pure juice pressed from green Thuja leaves, mixed with an equal quantity of alcohol.

However, if the patient was simultaneously suffering from another chronic ailment—as is common after aggressive treatment of fig-warts by allopathic physicians—we often find developed Psora [***] complicated with Sycosis, especially if the Psora was previously latent in the patient, which is often the case. Sometimes, if a poorly treated case of venereal chancre had preceded, both these miasmas combine into a threefold complication with Syphilis.

In such cases, it is first necessary to address the most affected component, the Psora, using the specific anti-Psora remedies described below. Then, remedies for Sycosis should be employed, before administering the appropriate dose of the best mercury preparation against the Syphilis, as will also be described below. This alternating treatment should continue until a complete cure is achieved. Crucially, each of these three types of medicine must be given sufficient time to complete its action.

[*] Materia Medica Pura, Part V.

[**] If further doses of Thuja are required, they are most efficiently used from other potencies (8th, 6th, 4th, 2nd). This change in the remedy’s modification facilitates and strengthens its ability to affect the vital force.

[***] Psora is rarely found in its developed state (and thus capable of complicating with other miasmas) in young people who have just been infected with fig-wart disease and have not undergone the usual mercurial treatment. This mercurial treatment invariably involves severe assaults on the constitution. Through this damaging disruption of the entire organism, Psora, even if slumbering ever so deeply, will be awakened if, as is often the case, it was already present.

For a reliable internal cure of Sycosis, no external remedy should be applied to the figwarts (except Thuja juice in stubborn, severe cases). If the figwarts are moist, only clean, dry lint should be used.

Syphilis

The second chronic miasma, more widespread than the genital wart disease (Sycosis), and which for three and a half (now four) centuries has been the source of many other chronic ailments, is the miasma of the true venereal disease, the chancre-disease (Syphilis). This disease is difficult to cure only when it is complicated with an already well-developed Psora. Complication with Sycosis is rare, and when it does occur, it is usually also accompanied by Psora.

In the treatment of venereal disease, three distinct scenarios must be distinguished:

1. When Syphilis is still isolated and accompanied by its characteristic local symptom, the chancre. Or, if the chancre has been removed by external applications, it is still accompanied by the other local symptom, the bubo, which similarly acts as a substitute for the internal disorder. [*]

2. When it is isolated, meaning without any complication with a second or third miasma, but has already been deprived of its substitute local symptom, the chancre (and the bubo).

3. When it is already complicated with another chronic disease, specifically an already developed Psora, while the local symptom may either still be present or may have been removed by local applications.

The chancre typically appears between the seventh and fourteenth days after unprotected sexual contact, rarely sooner or later, mostly on the infected organ. It first manifests as a small pustule that develops into an unclean ulcer with raised edges and stinging pains. If left untreated, this ulcer persists in the same location throughout a person’s life, only growing larger over the years. Crucially, the secondary symptoms of the venereal disease, Syphilis, cannot manifest as long as this chancre is present.

To address such a case, the Allopathic physician destroys this chancre using corrosive, cauterizing, and drying agents. They mistakenly believe it to be merely a sore caused by a local external infection, thus considering it a purely local ulcer, as stated in their writings. They falsely assume that when the chancre appears, no internal venereal disease has yet developed. Therefore, by locally eradicating the chancre, they believe they are instantly removing all venereal disease from the patient, provided the ulcer is not allowed to remain too long, preventing the absorbent vessels from transferring the poison into the internal organism and thus causing a delayed general infection of the system with Syphilis. They clearly do not understand that the venereal infection of the entire body begins at the very moment of unprotected sexual contact and is already complete before the chancre even appears.

In their blindness, Allopathic doctors destroy, through local applications, the substitute external symptom (the chancre ulcer) that benevolent nature intended to alleviate the extensive internal venereal disease. By doing so, they inexorably force the organism to replace this destroyed first substitute for the internal venereal illness (the chancre) with a far more painful substitute: the bubo, which rapidly progresses to form pus. And when the Allopath, as is often the case, also suppresses this bubo through their harmful treatment, nature is then compelled to manifest the internal illness through much more troublesome secondary ailments – the full outbreak of chronic Syphilis. Nature achieves this, albeit slowly (often not until several months have passed), but with unfailing certainty. Thus, instead of helping, the Allopath causes harm.

[*] Very rarely, unprotected sexual contact is immediately followed by a bubo alone, without any preceding chancre. More commonly, the bubo appears only after the chancre has been destroyed by local applications, serving as a very troublesome substitute for it.

Dr. John Hunter (1728-93) states: [*] “If a chancre is destroyed by mere external applications, not one patient in fifteen will escape Syphilis.” In another passage in his book [**] he adds: “Destroying a chancre, even on the very first day of its appearance, through local applications, invariably leads to the subsequent outbreak of Syphilis.”

Fabre declares just as emphatically: [***] “Syphilis invariably follows the destruction of a chancre by local applications.” He recounts how Petit excised a portion of a woman’s labia where a venereal chancre had been present for a few days; the wound healed, yet Syphilis still erupted.

Given all these facts and testimonies, how could physicians possibly ignore the truth? The entire venereal disease (Syphilis) had already developed internally before the chancre even appeared. It was an utterly unforgivable mistake to hasten the inevitable outbreak of this internally present Syphilis into a full-blown venereal disease by suppressing and destroying the chancre with external means. Doing so squandered an excellent opportunity to cure the disease in the easiest and most definitive way: through an internal specific remedy, while the chancre was still fully manifest! The disease is truly cured only when the chancre resolves solely through the effect of an internal remedy. It is completely extinguished only when the chancre is fully cured by the action of an internally acting medicine alone (without any external remedies), leaving no trace of its former presence.

[*] Treatise on the Venereal Disease, Leipzig, 1787, p. 531.

[**] Treatise on the Venereal Disease, Leipzig, 1787, pp. 551-553.

[***] Fabre, Lettres, Supplément, à son traité des maladies vénériennes. Paris, 1786.

Throughout my more than fifty years of medical practice, I have never observed the systemic venereal disease manifest as long as the chancre was left undisturbed at its site. This holds true even if this period extended for several years (as the chancre never resolves spontaneously), and even when it had significantly enlarged locally. Such local enlargement is a natural progression over time, mirroring the internal worsening of the venereal disorder, a pattern seen with the gradual increase of every chronic miasma.

However, if someone is so unwise as to destroy this vicarious local symptom, the body is then primed to allow the internal Syphilis to erupt into the full-blown venereal disease, because the generalized venereal disease has resided within the body from the very first moment of infection.

Indeed, the moment the syphilitic miasma is introduced and absorbed at the site of impure coition, it ceases to be merely local. The entire living body has already registered its presence; the miasma has already become an integral part of the whole organism. Any attempts at wiping or washing it away, no matter how quickly performed or with what fluid (and as we have observed, even surgical removal of the affected part), are too late—they are utterly futile. While no visible morbid changes may be apparent at that spot during the initial days, the specific venereal transformation irresistibly unfolds within the body from the very first moment of infection. This process continues until Syphilis has fully developed throughout the entire body. Only then (and not before) does nature, burdened by the internal illness, produce the local symptom characteristic of this malady—the chancre, typically at the initially infected site. Nature intends this symptom to alleviate the completed internal disease.

Consequently, the venereal disease is cured most easily and effectively as long as the chancre (or bubo) has not been suppressed by local applications, and as long as it remains undisturbed, serving as a vicarious symptom of the internal Syphilis. In this specific state, particularly when not yet complicated by Psora, it can be confidently stated, based on extensive experience and sound reasoning, that among all chronic miasmas and chronic diseases originating from a miasma, none is more curable or more easily curable than Syphilis.

The Simple Cure of Syphilis

In this initial, uncomplicated stage of Syphilis, when the chancre (or bubo) is still present, and there are no complications from a developed Psora, nor any significant chronic Psora-related ailments (which are typically absent in young, vibrant individuals). Furthermore, latent Psora combines with Syphilis as rarely as it does with Sycosis. In this specific first state, a single small dose of the most effective mercurial remedy is sufficient to completely and permanently cure the entire Syphilis, including its chancre, within fourteen days.

Within a few days of taking this mercury dose, the chancre (without any external treatment) transforms into a clean sore with a small amount of mild pus, and then heals spontaneously. This serves as convincing proof that the venereal disease has been entirely eradicated internally, leaving no scar or discolored spot on the skin. However, a chancre not treated externally would never heal unless the internal Syphilis had already been completely destroyed and extinguished by the mercury dose. As long as the chancre persists, it remains the natural and unmistakable sign of even the slightest trace of existing Syphilis.

Preparation of Mercurial Remedies

In the second edition of the first part of Materia Medica Pura (Dresden, 1822), I described the preparation of pure semi-oxide of mercury, which I still consider one of the most excellent anti-syphilitic medicines. However, it is challenging to prepare it with sufficient purity. Therefore, to achieve this desired outcome more simply, directly, and yet just as perfectly (as we cannot be too simple in medicine preparation), it is best to follow the method described below:

One grain of pure liquid mercury (running quick-silver) is triturated three times, each time with 100 grains of sugar of milk, for a total of three hours, reaching the millionth attenuation. Then, one grain of this third trituration is dissolved and subsequently potentized through twenty-seven diluting vials up to the decillionth degree (x), following the dynamization method for other dry medicines explained at the end of this volume.

Previously, I used the billionth dynamization (ii) of this preparation as a dose, administered on one, two, or three fine pellets moistened with the dilution, and this proved successful for such cures. However, higher potencies (iv, vi, viii), and ultimately the decillionth potency (x), offer certain advantages due to their quick, penetrating, yet mild action for this purpose. Nevertheless, in rare instances where a second or third dose might be necessary, a lower potency can then be used.

Just as the persistent presence of a chancre (or bubo) during treatment indicates ongoing Syphilis, conversely, when a chancre (and bubo) heals solely from internally administered mercury – without any additional local remedies – and disappears without a trace, it is undeniably certain that every vestige of internal Syphilis was eradicated the moment the chancre or bubo completely healed.

However, it is equally undeniable that if a chancre (or bubo) disappears merely due to local destruction – rather than a true cure based on eradicating the internal venereal disease with appropriate internal mercury medicine – then Syphilis undoubtedly persists. Anyone who believes themselves cured by such a superficial, local ’treatment’ remains just as afflicted with the venereal disease as they were before the chancre’s destruction.

The second scenario for treating Syphilis, as previously mentioned, is the rare instance where an otherwise healthy individual, free from other chronic diseases (and thus without any developed Psora), has had a chancre injudiciously suppressed by local applications. This might occur quickly, performed by an ordinary physician, without excessively burdening the organism with internal or external remedies. Even in such a case – since we don’t yet have to contend with any complication involving Psora – all outbreaks of secondary venereal disease can be avoided. The person can be freed from every trace of the venereal miasma through the simple internal cure described earlier, using a similar dose of the aforementioned mercurial medicine. However, the certainty of their cure cannot be as clearly demonstrated as if the chancre had still been present during this internal treatment, and had transformed into a mild ulcer and then visibly healed on its own, solely due to the internal remedy.

Even in this situation, a discerning observer can find a sign indicating either the incomplete or complete cure of the internal Syphilis, even if it hasn’t yet manifested as a full-blown venereal disease. If a chancre was suppressed by local application, even if the remedies weren’t very harsh, a discolored, reddish, red, or blue scar will always remain at the site, serving as a sign of unextinguished internal Syphilis. Conversely, when the entire venereal disease is cured by an internal remedy, and the chancre thus heals spontaneously without external applications – disappearing because it’s no longer needed as a substitute or alleviator for an internal venereal disorder that has now ceased – then the former chancre’s location becomes unrecognizable. The skin covering that area will be as smooth and uniformly colored as the surrounding skin, leaving no discernible trace of where the chancre once stood.

If the Homeopathic physician has carefully noted the discolored scar left after the rapid, purely local suppression of the venereal local symptom – recognizing it as a sign of unresolved internal Syphilis – and if the patient is otherwise in good health, meaning their syphilitic disorder is not yet complicated with Psora, then even now, the physician can free them from all traces of the venereal miasma with a single dose of the best mercury preparation, as previously described. The physician will be convinced of the cure’s completion when, during the specific remedy’s activity, the scar regains the healthy color of the surrounding skin, and all discoloration at that spot vanishes.

Similarly, even when a bubo has already appeared after the chancre was suppressed by local applications, but the patient is not yet suffering from any other chronic disease – meaning the internal Syphilis is not yet complicated with a developed Psora (though this is an uncommon situation) – the same treatment will still achieve a cure while the bubo is only developing. The completion of this cure will be recognized by the same signs.

In both these scenarios, if treated correctly, the cure is complete, and no further outbreak of the venereal disease needs to be feared.

The most challenging of all these cases, the third, remains to be discussed: this occurs when the individual, at the time of syphilitic infection, was already suffering from a chronic disease, so that their Syphilis was complicated with Psora even while the chancre was still present. Alternatively, it can happen when, despite no chronic disease being evident at the chancre’s outbreak (and the latent Psora could only be identified by its subtle signs), an allopathic physician has nevertheless suppressed the local symptom. This suppression was not only slow and involved very painful external applications but also subjected the patient to a prolonged internal treatment that was weakening and severely impactful. As a result, the patient’s overall health was compromised, and the Psora, which had previously been latent within them, was triggered and manifested as chronic ailments. These ailments then inextricably combine with the internal Syphilis, whose local symptom had been simultaneously destroyed in such an irrational manner. Psora can only complicate a venereal disease when it has developed and manifested as a clear chronic disease, not when it is still latent and dormant. While latent Psora does not hinder the cure of Syphilis, it becomes impossible to cure the venereal disease alone when it is complicated with developed Psora.

All too often, I must say, we find Syphilis, which has remained uncured after the solely local destruction of the chancre, complicated with awakened Psora. This is not always because Psora was already developed before the venereal infection—as this is rarely the case with young people—but because it is violently awakened and brought to its full manifestation by the usual treatment of the venereal disease. Through friction with mercury, large doses of calomel, corrosive sublimate, and similar harsh mercurial remedies (which cause fever, dysenteric abdominal ailments, chronic debilitating salivation, pains in the limbs, sleeplessness, etc., despite lacking sufficient anti-syphilitic power to cure the chancre-miasma gently, quickly, and completely), patients suffering from venereal disease are often subjected to these treatments for many months, often interspersed with many weakening warm baths and purgatives. As a result, the internally slumbering Psora (whose nature causes it to erupt during all significant systemic disturbances and general health decline) is awakened before Syphilis can be cured by such injudicious treatment, thus becoming associated and complicated with it.

In this manner, and through this combination, arises what is called a masked, spurious Syphilis, or in England, pseudo-syphilis—a monstrous double disease [*] that no physician until now has been able to cure. This is because no physician until now has understood the full scope and nature of Psora, neither in its latent nor its developed state; and no one suspected this dreadful combination with Syphilis, let alone recognized it. Therefore, no one could heal the developed Psora, which is the sole cause of the incurability of this hybrid Syphilis. Consequently, they could not free Syphilis from this horrible combination to make it curable, just as Psora remains incurable if Syphilis has not been eradicated.

[*] Indeed, after such a treatment, it is even more than a double disease; the sharp mercurial medicines, in large and frequent doses, have also added their medicinal disease, which, when we consider in addition the debility caused by such treatment, must place the patient in a most sad state. In such a case, Hepar sulphuris is probably to be preferred over pure sulphur.

Treatment of Masked Syphilis

To successfully treat this so-called masked venereal disease, the homoeopathic physician must follow this rule:

After removing all external harmful influences affecting the patient and establishing a light, yet nourishing and strengthening diet, the physician should first administer the anti-Psora medicine that is homoeopathically best suited to the patient’s current disease state, as will be detailed below. Once this medicine has completed its action, and perhaps a second one, most suitable to the still prominent Psora symptoms, these should be allowed to act against Psora until they have achieved all that can currently be done against it. Then, the previously described dose of the best mercurial preparation should be given to treat the venereal disease for three, five, or up to seven weeks; that is, for as long as it continues to produce an improvement in the venereal symptoms.

However, in stubborn and challenging cases, this initial course of treatment will likely not achieve all the desired results. Typically, some ailments and disorders will persist. These cannot be definitively categorized as purely Psora, nor can others be definitively categorized as purely Syphilis, and they will require further assistance.

Here, a similar process of cure must be repeated. This means first administering one or more of the unused anti-Psora remedies that are homœopathically most appropriate. This continues until any remaining non-syphilitic (i.e., psoric) morbid symptoms disappear. [Translator’s Note: Hahnemann is describing a sequential treatment strategy. He first addresses the psoric component that might be masking or co-existing with syphilis, then re-addresses the syphilitic component.] Only then should the previously mentioned mercurial remedy be given again, but in a different potency, and allowed to complete its action. This continues until all manifest venereal symptoms have entirely passed away. These symptoms include: the pricking, painful ulcer of the tonsils; the round, copper-colored spots that shimmer through the epidermis; the non-itching eruptive pimples found chiefly on the face with a bluish-red base; the painless cutaneous ulcers on the scalp and penis, which are smooth, pale, clean, merely covered with mucus, and almost level with the healthy skin; and the boring, nightly pains in the exostoses.

However, because these secondary venereal symptoms are so variable, their temporary disappearance does not guarantee their complete eradication. Therefore, we must also await a more conclusive sign of the complete extirpation of the venereal miasm: the return of healthy skin color and the complete disappearance of any discoloration in the scar remaining after a chancre was removed by local, corrosive applications.

In my practice, I have encountered only two cases of the rare threefold complication of the three chronic miasms: Sycosis (the figwart disease), Syphilis (the venereal chancre miasm), and a developed Psora, all present simultaneously. These cases were successfully treated using a specific method: Psora was addressed first, followed by whichever of the other two chronic miasms presented the most prominent symptoms at the time, and finally, the last miasm. Subsequently, any lingering Psora symptoms were combated with appropriate remedies. Finally, any remaining manifestations of Sycosis or Syphilis were treated using the remedies previously mentioned.

It is also important to note that the complete cure of Sycosis, even when it has permeated the entire organism before local symptoms appear, is evidenced—much like the cure of the chancre miasm (Syphilis)—by the total disappearance of skin discoloration at the site. This discoloration typically persists after merely local destruction of a figwart, serving as a clear sign of uneradicated Sycosis.

[Translator’s Note: The following is a case example illustrating the complex treatment described above.]

A master tiler from the Saxon-Erz Mountains, whose dissolute wife had infected him with a venereal disease in his genitals (it was unclear from his description whether it was a chancre or a figwart). He had been so severely mistreated by aggressive mercurial remedies that he lost his uvula. His nose was also gravely affected: most of its fleshy parts had been eaten away, and the remaining portion was swollen, inflamed, and riddled with honeycomb-like ulcers. This condition was accompanied by intense pain and an intolerably putrid smell. Additionally, he suffered from a Psora ulcer on his leg. Anti-psoric remedies brought about some improvement: they healed the leg ulcer and significantly reduced the burning pain and most of the putrid smell from his nose. Remedies for Sycosis also caused some improvement. However, overall, no further progress was made until he received a small dose of protoxide of mercury. Following this, everything fully healed, and he was restored to complete health, apart from the irreparable loss of his nose.

PSORA

Before delving into the doctrine of the third and most crucial chronic miasm, Psora, I find it necessary to offer the following general observation:

While infection with any of the three known chronic miasmatic diseases typically occurs in a single moment, the development of this initial spark of infection into a systemic illness affecting the entire organism requires a longer period. Only after a certain number of days, once the miasmatic disease has fully developed internally throughout the entire person, does the local symptom emerge from the depth of internal suffering. This symptom is, in a way, intended by benevolent nature to absorb the internal disease, thereby palliating and soothing it, preventing it from excessively harming and endangering the body’s vital functions. This local symptom typically appears on the least dangerous part of the body—the external skin—specifically, on the area of skin where the miasma first made contact with the nearest nerves during infection.

This natural process, which consistently and repeatedly manifests in the same way with chronic miasms—and even with acute and persistent ones—should not have eluded observant physicians. This is especially true for venereal diseases, which they have been treating for over three hundred years. Had they observed carefully, they would have been able to deduce the same natural process for the other two chronic miasms. It was, therefore, irrational and unforgivably thoughtless of them to assume that every chancre, which the organism develops after several days (often many days) as a result of a fully developed internal illness, was merely an external, accidental growth on the skin with no internal connection. They believed it could be simply removed by cauterizing “to prevent the poison from the chancre (namely, the internal disease itself) from being absorbed into the internal parts, thereby causing the person to suffer from venereal disease.” [Translator’s Note: Hahnemann is criticizing the old school’s belief that the chancre itself was the ‘poison’ rather than a manifestation of a deeper, internal disease.] This false notion about the origin of the venereal chancre was irrational and unforgivably thoughtless. It led to the harmful practice of externally cauterizing the chancre, which inevitably and regrettably resulted in the venereal disease erupting from its internally diseased state. This has occurred in hundreds of thousands of cases over the past three centuries. Equally irrational and thoughtless is the belief held by physicians of the old school, even in modern times, that itch is merely a skin disease in which the internal body plays no role. Based on this baseless assumption, they conclude that the best course of action is simply to remove this ailment from the skin’s surface. However, the eradication of the internal Psora disease, which causes the skin eruption, is essential. Once the internal disease is cured, the skin ailment—being a necessary consequence of the internal condition—will naturally disappear, because “when the cause ceases, the effect ceases.”

When Psora is in its complete state—meaning the original eruption is still visible on the skin, thereby alleviating the internal illness—the entire disease can be cured most easily, quickly, and reliably.

However, if this original skin eruption, which serves as a substitute for the internal illness, is suppressed or destroyed, Psora is then forced into an unnatural state. It begins to dominate the internal, more delicate parts of the entire organism in a one-sided manner, leading to the development of its secondary symptoms.

The critical importance of the skin eruption for original Psora, and why any external removal of the eruption must be meticulously avoided during the only true and thorough cure for itch (which is an internal cure), becomes clear when we observe the following: The most severe chronic ailments often emerge as secondary symptoms of internal Psora after the original itch-eruption has been suppressed. Conversely, if, due to a significant shift within the organism, this itching eruption reappears on the skin, the secondary symptoms vanish so abruptly that these severe, often long-standing ailments tend to disappear, at least temporarily, as if by a miracle. Refer to the previously cited observations by older physicians, Nos. 1, 3, 5, 6, 8, (9), 16, (17), (21), 23, 33, 35, 39, 41, 54, 58, 60, 72, 81, 87, 89, 94.

However, it is crucial not to assume that an internal Psora, which has developed into secondary chronic ailments after the external suppression of the original skin eruption, can return to its previous normal state simply because an itch-like eruption reappears on the skin. Nor should one believe it can be cured as easily as if the original eruption were still present and had never been removed.

This is simply not the case. Even the eruption that appears immediately after the infection does not possess the unwavering persistence and stability on the skin that a chancre or figwarts exhibit at their initial sites of appearance.[] Instead, it often disappears from the skin due to various other factors []—not just from the deliberate use of artificial remedies to suppress it, but also from other unknown causes.[]

Therefore, the physician must not delay treatment, even for the initial eruption, if they wish to achieve a complete cure while the Psora (the itch-disease) is still in its initial, less complicated state, by using internal anti-Psora remedies. Such a delay is even less advisable for a secondary eruption, which appears on the skin for any reason after the initial eruption has been locally suppressed. This is because the secondary eruption tends to be far more inconsistent and variable, often fading away with much less provocation within a few days. This proves that it lacks many of the full characteristics of the primary Psora eruption, meaning the physician cannot rely on it for a thorough cure of Psora.

This tendency for the secondary Psora-like eruption to change seems clearly due to the internal Psora, after the suppression of the original eruption, being unable to impart the full characteristics of the primary eruption to the secondary one. At this stage, the internal Psora is already much more prone to manifest as a variety of other chronic diseases. Consequently, a thorough cure is now much more challenging and must be approached as if treating the internal Psora directly.

Therefore, the cure is not advanced by intentionally inducing such a secondary eruption with internal remedies, as has sometimes been attempted (see Nos. 3, 9, 59, 89); nor by its reappearance due to other unknown causes (see Nos. 1, 5, 6, 8, 16, 23, 28, 29, 33, 35, 39, 41, 54, 58, 60, 72, 80, 81, 87, 89, 94); nor, especially, with the aid of a fever (see No. 64, also 55, 56, 74). Such a secondary eruption is always very transient, unreliable, and rare, making it impossible to base our hope of cure on it or expect it to advance any thorough cure.

[*] Neither a chancre nor figwarts ever disappear on their own, unless intentionally destroyed externally or the entire underlying disease is healed internally.

[**] For example, due to cold (see observation No. 67), smallpox (No. 39), or warm baths (No. 35).

[***] See observations Nos. 9, 7, 26 (36), 50, 58, 61, 64, 65. These observations also show that after such disappearances of the original Psora eruption without any apparent cause, just as many negative effects tend to follow as when it has been artificially suppressed through local applications.