by HERBERT A. ROBERTS, M.D.

Preface

Chapter:

I- What has homœopathy to offer the young man?
II- Introduction to the study of homœopathy.
III- Vital force.
IV- Vital force as expressed in functions: In health, in disease, in recovery, in cure.
V- Vital energy in its universal application.
VI- Homœopathy and the fundamental laws.

VII- Our remedies: Why they act.
VIII- Taking the case.
IX- Analysis of the case.
X- The law of cure.
XI- The chief complaint and the auxiliary symptoms in their relation to the case.
XII- The dynamic action of drugs.
XIII- The dose.
XIV- Remedy reaction.
XV- Drug proving.
XVI- The second prescription.
XVII- Susceptibility.
XVIII- Suppression.
XIX- The law of palliation.
XX- Temperaments.
XXI- Local applications.
XXII- Disease classification.
XXIII- Disease classification: Psora (Continued).
XXIV- Psora or deficiency?
XXV- Some manifestations of latent psora.
XXVI- Disease classification: The syphilitic stigma.
XXVII- Disease classification: The syphilitic stigma (Continued).
XXVIII- Syphilis.
XXIX- Disease classification: Sycosis.
XXX- Sycosis – Over-construction.
XXXI- Disease classification: A summary.
XXXII- Homœopathic therapeutics in the field of endocrinology.
XXXIII- The phenomenological viewpoint.
XXXIV- The deflected current.
XXXV- Modern medication and the homœopathic principles.

This work is dedicated to all seekers after truth in healing of every age and race.

* * * * *

The signs > and < used in this book are abbreviations common to all homœpathic publications. They signify:
>: Better; less pain; more ease.
<: Worse; painful; uneasy.

CHAPTER XXXV
MODERN MEDICATION AND THE HOMŒOPATHIC PRINCIPLES

     Like all principles, those of homœopathy have been discovered and evolved through the crucibles of time, experimentation, and increasing enlightenment. Like all principles, too, they stand whether or not they have the ascription of those who profess to be their adherents. They are principles that, to those who under-stand and seek to apply them and to those who benefit from their application, stand preeminent, unchangeable, in spite of all changes in therapeutic fashions. To principles there is no time element. Natural law knows no ancient, no modern. Time offers only the greater opportunity for examination of the results of applied principles, the action of the natural laws; and evolution knows not the meaning of fashion.

     The word modern must always be used in a comparative sense. This is never appreciated more keenly than when considered in the light of medical practice, and those elements of the practice of today that have survived the crucible of time have rightly become recognized as the principles of the art.

     Medicine, while always dealing with the ills of mankind, has passed through a continuous barrage of “modern” discoveries. Greater possibilities of investigation of the functions of the body have increased our knowledge of life processes and the circumstances of living; and this increase in knowledge has been of inestimable value in dealing with human suffering. But therapeutics, as demonstrated by modern medicine, is still in a state similar to that of the past, in that the discovery or development of the day is the seeming answer to almost all therapeutic problems. This is another way of saying that in spite of the increased knowledge of the mechanism of the body, no guiding principles have been discovered by the dominant school of medicine that are sure and certain indications in the field of therapeutics. That means there is no test but that of experience for any therapeutic agent, and modern medicine, despite the period of its discovery, still finds itself on a basis of empiricism rather than of true science.

     Consider the discovery of the synthetic group of drugs. There has been a continuous procession of these substances over a period of years. Aspirin, luminol, the phenols, the sulphanilamides, the vitamins and numerous others. Each discovery has been hailed as a modern development of science for the conquering or alleviation of the ills of mankind. Sober investigation of the claims of these therapeutic measures astounds us with the conviction that in almost every instance the target at which these measures are aimed is a single symptom or, at most, a small group of symptoms, and not at the patient himself. In most cases the discovery of such a therapeutic agent has been met with loud acclaim and ardent advertising; its use became widespread very shortly. Soon the sincere students of science perceived, through their laboratory research and from clinical observations, that there was another face to the seeming curative action of the substance, that was not without danger to the patient; and therefore warnings were sent out that there should not be too free use of the substances except under the most careful observation. In the meantime the fashion of use had spread, especially among those who always seek the easy road in therapeutics, the uninstructed and those who are addicted to self-dosing, with a corresponding amount of further damage to health.

     Such an agent was aspirin. First advanced for its harmless sedative properties in the control of pain, it was widely used and in considerable amounts, by physician and laymen alike, until its depressant properties came to be respected by careful therapeutists. The American Medical Association found it advisable to publish warnings against the use of this substance which was commonly sold under the trade name of aspirin; but the use of the substance was not curtailed to any marked degree except by the most careful prescribers. It had become a cure-all for domestic use and all too often in hospitals and by physicians who sought first the suppression of the distressing symptoms rather than the cure of the patient.

     Homœopathic physicians have long known the dangers of suppressive measures, and have always had due respect for the innate powers of any medicament. It was Hahnemann who observed that any drug was poisonous if dangerous dosage was given. Therefore it is to be expected that homœopathic physicians early recognized the dangers of the synthetic drugs, among them the coal-tar derivatives. The ability of the trained homœopath to observe and correlate symptoms made it a foregone conclusion that he would easily trace the depressed vitality, the heart attacks, and many collapsed conditions, to the frequent use of aspirin and like pain-killers.

     The homœopathic physician is likewise trained to realize the dangers of suppressed or masked symptoms; that pain has its beneficent aspect as a guidepost, and that the discomforts of an acute cold or grippe cannot be suppressed without grave danger to the ultimate health of the patient. The prevalence of the symptom “never been well since” is proof of this.

     The phenols, and especially phenobarbital, were hailed loudly as curative, and especially as palliative of many ills. It was not long before their deadly nature was discovered, and the warnings were posted against their use. They are still used extensively, but much more conservatively than formerly. In many of these instances, it is the early dangerous action that is discovered and the later, more insidious and long lasting effects are undiscovered or ignored until too late; these become constitutional and therefore are unrecognized.

     Of course all these effects, from first to last, are homœopathic proof of the potentialities of cure that lie in these synthetic drugs. To the homœopath, however, there should be but one criterion for their use-the similarity of symptoms produced in the healthy for application to like ills in the sick.

     The popular sulphanilamides are one of the best instances of the powers and dangers of synthetic drugs. They have been hailed for their powerful action in infections of many -one is tempted to say all- kinds. It is true that in laboratory and clinic they have proven this power. But along with the proven power of destroying invading organisms they have a like danger to normal cell balance; this has been recognized by those who developed the drug to the point where careful therapeutists will not use these agents without keeping careful laboratory check on the blood steam and other functions of the patient.

     Probably more variations of this group of the drugs have been developed than of any other that has become popular. When sulphanilamide was first publicly recognized and marketed, it was permitted to fall into the hands of laymen who had read glowing accounts of its value and who decided that they could cure them-selves of all their ailments with this wonderful panacea. Numbers of these hopeful sufferers purchased, and many deaths resulted. Manufacturers of the products were obliged to keep a closer watch on the production and distribution, and research chemists set about developing less dangerous combinations.

     The fact remains that where medicinal agents are capable of eradicating organisms by any other method than by stimulation of the dynamic force to the point where nature itself balances the scale, there is danger to the patient, sooner or later.

     It is no doubt true that sulphanilamide and its variations have a comparatively good record in such conditions as pneumonia and like infections. That is, a good record compared to that of the dominant school where pneumonia is a dangerous and often fatal disease. The sulphonamides have so far given a more creditable record than the serum treatments of pneumonia which were so well sung only a few years ago; and in the use of the sulphonamides only prompt use is necessary-one may omit the typing and thus save time. In fact, it has been said by eminent authorities on the use of the sulphonamides that in infections they must be used promptly in the onset of the infection of whatever kind, or they are useless.

     Let us analyze this situation. Here we are given a therapeutic agent that will kill the invading organism, with a corresponding dangerous action against normal functions of the body; yet potent as this is, it is of no value against the invading organism after that has become established. Are we to believe that its danger to the normal cells of the patient has diminished in proportion to its possibilities of help against the invader?

     It has been many years since the possibility of sterile death has been acknowledged -the blood stream being sterilized of invading organisms, yet death results. This is as true now as then; and the danger may be imminent or retarded in relation to the amount of the crude dosage or the frequency of its administration. Careful observers in both schools of medicine have noted the slow return to normal health of patients “cured” i. e. the acute infection having been overcome, by heroic methods- or as we may better say, by the application of forces outside the normal functions of the body. Therefore, although the invading organisms have been limited in action, the system has to overcome the effects of the infection plus the toxic effects of the treatment.

     Now let us consider the sulphonamides in relation to the homœopathic principles. We might consider, in the light of our thesis, any or all of the synthetic drugs, but so far as we know there has been no effect to exhibit the potential powers of the sub-stances through the well known and thoroughly tried method of Hahnemann-that of proving the remedy on the healthy human being. Such an attempt has been made in the case of sulphanilamide, notably by Dr. Allan D. Sutherland; the results of this fragmentary proving were published in the Homœopathic Recorder for September, 1940.

     Dr. Sutherland’s conclusions were that this substance, potentized, has great possibilities as a homœopathic remedy when we have more clearly demonstrated its field of usefulness by the sure guide of the symptomatic outlines that our principles demand; these are the only guides which provide safety in cure rather than uncertain palliation of a condition that the patient later has to overcome through his natural vitality, or else succumb to in some other and more deeply constitutional form at a later date.

     The homœopathic adage that we try to cure the patient rather than the disease might well be supplemented by the statement that we do not presume to snatch the patient from an acute illness from which, by the grace of his dynamic energies, he might well recover (acute illnesses being always self-limiting) to foist upon him a constitutional condition plus the imposed drug illness, from which he may never recover.

     The results of the homœopathic remedies in such infections as pneumonia, grippe, streptococcus, staphylococcus and other generalized or local infections have been more remarkable than in any other system of medication. This is a simple way of saying that the natural laws, upon which homœopathy is founded and upon which our principles are based, work just as surely in serious, swift-paced onslaughts of disease as in any other condition. It is true that in some of these conditions the system is more deeply involved and death more imminent than in many conditions we are called upon to treat. It is also true that many of these serious infections were cured before the laboratories were at hand to furnish accurate diagnoses, and that very often the most prominent result of a laboratory diagnosis is to weaken the courage of the physician, the patient, and the patient’s family.

     The homœopathic physician recognizes another important principle in these serious states; the more acute the case, the more the infection strikes at the life of the patient, the more clearly indicative are the symptoms. Obscuration of symptoms (unless produced by crude drugging) is very rare in a case of acute infection. The homœopathic remedy works regardless of the name of the disease, and works, moreover, toward a true and complete cure, without sequelæ or constitutional involvement.

     The value of vitamins in the diet has been a burning subject among research chemists and therapeutists alike. The source of vitamins in natural foods, especially raw fruits, has been recognized for some time; and of course sources of synthetic vitamins have been discovered and their use urged through the drug houses. One simple but obvious fact seems always to be overlooked by the manufacturing chemists-that while chemically the synthetic product may vary little from the natural, there is a difference which is recognizable in results, sometimes far removed in time from the experimental stage. It is hardly likely that a patient would suffer from too many vitamins through a normal diet; the vitamin is normally balanced with the other food values.

     With the increased regard for vitamins as necessity of life, we are now under a barrage of foodstuffs where added synthetic vitamins are an ineradicable part of the diet. Since it has been found that these substances are necessary to life and development, argue the laboratory chemists, therefore as a nation we must take advantage of this source of increased energy and vigor; and since the synthetic vitamins have the same chemical construction and are easily available at a comparatively low cost, we must use these vitamins to the fullest extent, therefore they are introduced into many basic foods such as flour, etc. Thus we have a business venture which is very profitable to the producers of the vitamins, and it becomes almost impossible for an individual to escape a diet heavily laden with synthetic vitamins.

     Now, however, the careful research men who investigate carefully all sides of the question and take time to correlate facts, are beginning to voice the conclusion that after long and critical study they find there is as great danger from too many vitamins as from too few, and perhaps more. This is a statement in accord with homœopathic principles, and with the laws of nature governing balance in all things: “The amount necessary to effect any change in nature is the least possible;” “Action and reaction are equal and opposite.”

     The manufacturing chemist states in his literature that it has been determined that the normal vitamin requirement is from 3 to 25 milligrams per day. We may expect that overdosing with vitamins, which have a constructive and maintenance value, would have two definite reactions: first, a destructive action proportionate to its normal constructive action; and second, the permanent disability of the system to react to normal vitamin intake. This latter is comparable to the effect of insulin administration in the diabetic patient; he soon loses his ability to produce the necessary secretion in his own economy. This is another illustration of the loss of a function by the need being supplied through no effort of the patient, and evolution bears witness to the fact that what a creature does not use he must lose. Thus the excess supply of vitamins robs the body of its normal reception of the natural vitamins.

     One can hardly conceive of the effect of a high vitamin intake on the younger generation in the light of this conclusion. And we can hardly fail to consider the results of the unrestricted administration of these elements in future generations; will they be able to assimilate them from natural sources, or will there be, after a time, some radical change in the human economy to compensate?

     In particular, we may inquire regarding the reactions in the special functions; will these functions be permanently affected? For instance, it has been demonstrated that vitamins C and D help to overcome rickets, and that a certain amount of these are necessary for the proper growth and development of the body structure. it has also been demonstrated that excessive doses will cause rickets. Since vitamin E is supposed to stimulate the generative function, will massive dosing destroy or impair this function? We might continue this analogy through the list of vitamins so far isolated and studied.

     It is well for us, as homœopathic physicians, not to overlook the potentialities of the synthetics in the field of therapeutics; but we must examine them carefully in the light of our well-proven homœopathic principles, remembering also that the findings of the clinic do not necessarily bear the same relationship to the human patient as to the laboratory animal, and that the secondary results may vary widely from -nay, be directly opposite to- the primary results which appear to be so brilliant and satisfactory.

     We must remember that our homœopathic laws, if they are natural laws, as we have every reason to believe, are still worthy of our consideration and that no sure guidance has yet been found that is not in accordance with those laws; and that the test of time must be applied in every instance of a new discovery that has not been tried according to known law. It is foolish to reject the new just because it is new, but it is even more foolish to accept every new finding blindly without fully testing its validity when we have at hand all the means for sound procedure, means which the dominant school so far has failed to accept.

CHAPTER XXXIV
THE DEFLECTED CURRENT

     We are told that light waves travel in a certain direction until they meet some obstacle, when they are deflected at an angle proportionate to the angle of interference. We are told that our remedies are curative in conditions closely similar to those produced by the remedy in a healthy human being.

     The science of optics can give us, with a very small percentage of error, the measurement of the light waves, their angles of deflection and the measurements necessary to correct vision or to utilize the light waves in some practical manner. In other words, there is a definite measurable approach through known laws to the application of light waves to our modern needs; and we may be assured that with growth in our needs, and a greater understanding of those laws and measurements, future generations will be able to utilize light waves to a far greater degree than is thought of at the present time.

     The homœopathic laws are fundamental; we understand many of them; we utilize them. Unfortunately, we have no such instruments of precision by which we can measure the obstacles to the curative waves of our remedies. Therefore we have no uniform results from our remedies such as we might expect from the vast armamentarium of remedies and the compilation of knowledge and experience garnered by successful homœopathic students since the time of Hahnemann.

     Some of our confreres will say, at this point, that such instruments of precision are being used by homœopathic physicians at the present time; that they are daily being perfected and that the results are increasingly satisfactory. No doubt all of this is true; yet for the average homœopathic student we feel that such means are not yet available, or if available, the technique has not been sufficiently mastered by the average physician to be handled with accuracy; or perhaps the degree of perfection (or imperfection) of such instruments interferes with capable usage.

     However this may be, our thesis has to do with the average homœopathic physician, and may be reduced to that all too well known question: why are our results not uniformly satisfactory? Why doesn’t the seemingly indicated remedy always work?

     Of course there are the answers known to every physician of whatever school, and some that only the homœopathic physician recognizes.

     One obvious reason is the pathological condition of the patient. The röentgenologist and the surgeon are most apt to known about such pathological obstacles than is the homœopathic physician, but they so lack the means to cure that their knowledge teaches them only to remove offending tissue; perhaps the patient recovers by the aid of beneficent nature. It is trite but true that more mistakes are made by not looking than by not knowing.

     On the other hand, there are serious homœopathic students who have come to believe that treatment of pathological conditions by X-ray or radium dissipates, rather than cures, the pathological tissue. Certainly we have seen the results of over-exposure to such treatments, with the insuperable obstacle to cure that has been thus raised. Destruction of normal tissue, under such treatment, may prove as dangerous to the patient’s health as lack of treatment; and the relation of metastasis to surgery, X-ray or radium treatment is still an open question in the minds of many close observers.

     Then there are the states which arise from mechanical obstruction, non-pathological but the actual presence of a foreign body, which gives rise to reflex symptoms of exceedingly troublesome nature. Of course the remedy does not and cannot cure such symptoms so long as the causative factor remains. Persistent earaches or coryzas in children who have inserted small objects into the ear or nose have their counterpart in the suffering of adults, often from unusual minor accidents.

     Psychic trauma, emotional stresses of varying degrees and insistence, are factors that we, as homœopathic prescribers, should understand and weigh thoroughly in view of the patient’s symptomatology. However, frequently the patient does not consider his private affairs the business of any outside, even of the physician, and keeps these important items to himself. Or he may be so used to bearing his own burdens that he does not recognize them as having any weight in the case; or he may (consciously or unconsciously) distort the picture of his own mental stress so much that even if he reveals the difficulty under which he is labouring, the whole picture may be of little help to the physician in analyzing the case.

     It was Hahnemann himself who emphasized the fact that nothing was so deleterious to health as unhappy domestic conditions; that these conditions could, and often did, prove insuperable obstacles to cure. It is fortunate that the simillimum often can take the additional tension from the patient, or may lift off one series of symptoms; but so long as these strains persist under the surface, one cannot expect cure. Nevertheless, if the physician does not realize that these underlying influences exist, he may fall so far short of helping the patient that he may imperil his own belief in the homœopathic possibilities of cure, as well as the confidence of the patient.

     Over-anxiety, worry, constant financial stress, the tension of maintaining speed in one’s work, peculiar industrial demands-all these and many like stresses have developed unusual influences upon our patients during the past few years, and have correspondingly lowered the percentage of possible cures. They have served to deflect the current of cure in whole or in part; and the homœopathic system of medicine is not at fault in such deflection of cure so long as these conditions remain a vital part of the patient’s life.

     Along with such conditions the physician has to fight the in-creasing use of sedatives, bromides, narcotics, analgesics-all forms of drugging which offer the patient some retreat from the pressure of the modern age or some measure of relief from pain, either mental or physical. Often the physician does not know of the home prescribing of the patient with such products of the pharmacist, but modern advertising keeps these products before the mind of the public to such an extent that they have proved one of the greatest barriers to cure ever known.

     In these cases one must know the obstacle to cure if he is to be able to serve the patient with any degree of real assistance; although it is one of the greatest boons of homœopathy that so many of our remedies have in themselves the power to antidote massive drugs, and so release the vital power inherent in the patient himself, with the corresponding response towards cure.

     Cosmetics may prove the obstacle to cure just as surely as narcotics or coal-tar derivatives. Many cosmetic preparations contain substances advertised to suppress perspiration, eruptions, or to remove hair growth. Most physicians see cases definitely traceable to such measures. The suppressed eruptions and their sequelæ are endless. We have seen a case of progressive paralysis in a young woman which she herself traced to the use of a depilatory preparation.

     An eminent contemporary prescriber reported a case of a persistent Coccus cacti cough which refused to yield-until he ordered the young woman to stop the use of her lipstick, when the cough ceased.

     Even the “old school” pharmaceutical journals are beginning to report a great variety of cases which have been traced to per-fumes or perfumed cosmetics, and even to cite the physiological action of their ingredients. It is notable that some of these cases occurred, not in users of the cosmetic products, but in those associated with them. The homœopathic physician under-stands the power of ambergris, musk, etc., to produce symptoms in the potency. Hahnemann taught the power of olfaction on sensitive patients. Modern medical lore is full of the allergic reactions of sensitive patients to a variety of substances, in the most minute form. When even the dominant school of medicine recognizes this hazard, the homœopathic physician must never neglect consideration of such a deflection of the current.

     Then there is the problem of diet. The so-called soft drinks follow closely the record of home drugging in distorting the case. The modern craze for slender figures, with the unbalanced diets prescribed by the laity, may be an obstacle to cure; not because the physician cannot correct the condition with a proper balanced diet plus an indicated remedy, but because of the psychological barrier-the unwillingness to accept a suitable diet with the corresponding normal weight. In other words, the patient who suffers willingly from malnutrition can be brought back to normal only if his co-operation is gained, or if the case comes to the physician before dangerous physiological changes set in. On the other hand, there is the malnutrition resulting from an unbalanced diet directly traceable to depressed budget; this condition has grown rapidly during the depression years and the effects are still shown in many cases. This has to be met not only with the homœopathic remedy but with economic equilibrium and a well thought out diet if the patient is to be cured. Here we meet an economic obstacle that is often beyond the help of the physician.

     The question of proper exercise would seem to lie within the province of the physician. We recall one case, however, where the patient, a woman past middle life, was instructed to get out of the house, into the open, and cultivate her interest in wild flowers, thus getting her interests outside herself along with fresh air and sunshine. We supposed the prescription was being filled, as we were greeted with fresh wild flowers every call we made, but she did not seem to gain in strength nor did her color improve. Some time later (after she left us for a more sympathetic physician) we found that her husband faithfully went to the fields and gathered fresh flowers for the vases, while she rested from the prospect of his endeavors in her behalf.

     There are patients who cannot take strenuous exercise because of pathological obstacles. There are patients who are so restricted by circumstances that they get little opportunity for exercise in the open air. But such patients are usually chronics with a long history and a poor prognosis; we usually accept the situation and do the best we can toward homœopathic palliation, and surprising as it may be to us, we sometimes approach cure in spite of the difficulties. But the patient who can co-operate, but will not, and perhaps even leads us to believe she has made the attempt, herself deflects the current of cure at its very source. Then we question the value of our prescription and wonder why the indicated remedy failed to work.

     One of our hardest problems is the patient who cannot seem to rally-the old chronic, with a long but seemingly not overwhelming history, and with a clear picture of a remedy. Somewhere here there is an obstacle to cure and we must plumb the history -physical, mental, emotional- to remove that obstacle or measure it, and to me sure as well our remedy and its potency, to determine whether it is the simillimum in likeness of symptomatology and energy.

     Another obstacle to cure is the ease with which the physician’s judgment may be overbalanced in favor of the patient’s favourite symptom. This may seem a trifling matter, but frequent repetition of a troublesome symptom may so warp the true picture of the case that the symptomatology seems to reflect an entirely different remedy than those true, but less conspicuous indications, that are actually present. The patient does this unconsciously by remembering the most troublesome factors and forgetting the seemingly minor items that should furnish the clue to the remedy.

     We have discussed some of the obstacles to cure as they affect the patient or the physician. Let us discuss the other side of the problem; the remedy.

     Here our first problem is the source of the remedy itself. How close to Hahnemann’s standard did the source of our remedy approach? In other words, how carefully did the homœopathic pharmacist identify the source of his supply? Is the plant identical with the botanical source of our proving? We cannot expect a Rhus tox. case, for instance, to be cured with some other member of the family, if we have depended upon the proving of Rhus tox. as our guide. Here we enter the field of similars instead of the simillimum. Was the original supply fresh and in good condition? Substances of inferior quality cannot provide a good potency. With what degree of thoroughness did the pharmacist follow Hahnemann’s instructions for potentization? With what degree of thoroughness did the provers follow instructions?

     We must be able to depend absolutely upon the sources of our remedies, and if there has been carelessness in gathering the original substance, in any part of the process of making the potency, in contamination in handling the potency or in discrepancies in recording the provings, then we cannot but expect that the current of cure will be deflected. All these details are known to the homœopathic prescriber, but we cannot refrain from pointing out that these details may spell the difference between life and death, certainly between cure and failure, in many of our cases where there seems to be no reason to expect a deflection of the current of cure.

     We question whether the provings were made under proper control. How many entered into the proving? How accurately was the substance, the origin of the potency, labeled? Inaccurate labeling might be the difference in possible cure or deflection by an insurmountable obstacle.

     Weighing the symptoms of the patient against those of the remedy is one of our major problems; but an even more important problem is the weighing of symptoms of the proving itself. How great a value, we ask ourselves, shall we place upon those symptoms occasionally or rarely produced in a proving? We are told, for instance, that the time aggravation which is almost a keynote of Kali carb. appared in only one prover, yet it has been clinically confirmed so frequently that we often think of it as one of the leading symptoms of Kali carb. -or when we think of the 3 a.m. aggravation we immediately think of Kali carb., in spite of the fact that Kent’s Repertory lists a number of remedies with this modality.

     It is important that we use every means within our power to determine whether or not the occasional symptom comes from the individuality of the remedy or whether it is a deflection of the remedy’s dynamis through idiosyncrasies of the patient or through something the patient may do or may use that distorts the reaction. Here is a patient, for instance, who cannot take Hepar Sulph. without producing a symptom not appearing in any of our Hepar provings -a sensation as if a finger and thumb were pressing either side of the larynx. Is this a valuable symptom or is it an individual reaction of no value?

     Hahnemann gave us very clear directions for making provings, and instructed us that in every case the usual habits and diet of the prover remain at ordinary level during the proving, so that we might know whether or not the symptoms were produced by the remedy or by changes in the prover’s habits. However, it is conceivable that such things as diet, etc., even if the patient had become accustomed to them, might deflect the current of symptoms in like degree to the disturbing element in the dietary. We reflect that such articles of diet as coffee, which we are taught affects the action of certain remedies when prescribed for curative purposes, might in like degree modify the reaction of the remedy in its proving, either to completely nullify part of the symptomatology or to modify it to an entirely different picture. Thus we must use every care in adopting casual provings. In the case of Hahnemann’s provings, he reduced them to what approaches a mathematical formula. He carefully weighed the habits, diet and general state of health as manifested by symptomatic reaction of each prover before such prover was accepted for service. This data was subtracted, as it were, from such symptomatology as appeared during the course of the proving or within reasonable time thereafter, and the remaining symptoms were credited to the remedy action. Moreover, this procedure was well controlled by the number of provers for each remedy. These details were watched with the precision characteristic of Hahnemann.

     A word about keynotes as a possible obstacle to cure is not out of place. Keynote symptoms have proved themselves as of almost equal degree a bane or a blessing. With our vast array of remedies the average homœopathic physician learns well the polychrests; thereafter, depending upon their relationship to his practice, he tends to depend upon memorizing a more or less brief outline of remedies. Many remedies he knows only by keynotes. If these keynotes are used as a reference to materia medica study they serve well, but they are very dangerous for a basis in prescribing. If he prescribes solely on the keynote he may and often does, remove the conspicuous symptoms; but this may serve only as an obstacle to cure by deflecting the current of symptomatology and thus distorting the picture of the patient himself.

     ”The physician should distinctly understand the following conditions’; what is curable in diseases in general, and in each individual case in particular… He should clearly comprehend what is curative in drugs in general, and in each drug in particular… He should be governed by distinct reasons, in order to insure recovery, by adapting what is curative in medicines to what he has recognized as undoubtedly morbid in a patient… Finally, when the physician knows in each case the obstacles in the way of recovery, and how to remove them, he is prepared to act thoroughly, and to the purpose, as a true master of the art of healing.”

CHAPTER XXXIII
THE PHENOMENOLOGICAL VIEWPOINT

     In his introduction to his book, Philosophy and the Concepts of Modern Science (1935), Oliver L. Reiser, Associate Professor of Philosophy, University of Pittsburgh, tells us that the one possible method of:

     … integrating the vast and unwieldly masses of facts of the sciences into meaningful wholes the adoption of a phenomenological viewpoint is recommended. By phenomenology is meant a study of that which exhibits or displays itself: it is the descriptive point of view obtained by viewing the thing as a whole. Much of the trouble.. comes from an over-emphasis upon microscopic details. Thus it comes about that we can no longer see the forest for the trees.

     One of the really great discoveries of recent times is what has been termed the principle of uniformitarianism by the geologists; that is, the theory that the forces now at work are identical in nature with those that produced changes in past ages.

     If we take this phenomenological view of science to-day, we cannot help but see that Reiser’s comment on the over-emphasis upon microscopic details as being the source of multiplied data and chaotic theories of cause, action and effect is all too true. The strain of application of the micro-scope has produced a mental and philosophical astigmatism that permits each part to attain disproportionate focus in the whole.

     Medicine, in particular, needs to view the whole and to take into consideration the principle of uniformitarianism. So far, as has been acknowledged by eminent authorities in the dominant school, homœopathy alone has offered such a unified theory that embraces the cause of diseased conditions, the course of the condition and its prognosis; and at the same time the method of approach to the remedial agent, and the prognosis of its action upon the patient based upon the knowledge of the patient, the knowledge of the remedy, and a comprehension of the laws and their expression in varying states of health and disease. This is another way of saying that the homœopathic concept of disease and cure is from the phenomenological viewpoint in that it considers the broad outlines of the whole rather than some of the minutes divisions compassed by microscopic vision, and at the same time embraces the meaning of which the microscopic vision demonstrates but a part.

     It is safe to say that the revelations in science yet to come are even more vital and far-reaching than those already exhibited. The specialist in specific branches of medical investigation can furnish us vast and detailed information based on his microscopic findings; yet as homœopathic physicians we cannot permit ourselves to be hampered by details to the exclusion of the whole. We are privileged to view all these findings as a part of the universal application of a Law under which we work; for Man is naught if he be not a part of the Universe and subject to its laws.

     Because man’s adaptation is highly specialized, we are able to correlate, through a study of his health variations and the fundamental laws of the universe (as far as we can determine these), our knowledge of each towards greater comprehension and applicability of the greater to the individual problem. Animal life, like vegetable life, has a high degree of adaptability to environment and proves the most delicate laboratory we have for our examination; yet the mineral kingdom furnishes us with an unsuspected link in our chain of evidence. Thus in conformity with statistical laws, we find again and again that the regular reaction of response of an individual is true of a group of individuals (with the necessary dedications for personal idiosyncrasies) and further, that what is true of a group of individuals may be true of any other group in nature under similar conditions, so far as we can measure the reactibility of these other groups. This uniformity of results is unquestionably due to what we term Universal Energy, which may be expressed again in very modern terms as those basic electrons, protons, neutrons, which are radiate, electric, magnetic-the very definition of potential energy.

     While energy has a certain stability of reactivity, it has selective action. Every portion of the human frame has a selective action over its function: it is susceptible to certain influences, constructive and destructive, and reacts selectively. Each atom of the human frame has a potential susceptibility to certain influences, and has developed selectively and according to the principles of uniformitarianism; and we are now by means in a static condition, socially, economically or physically, any more than the geological formation of the present day is in a static condition, although both man and rocks may seem to be.

     In reality, we are continually in balance between dynamical laws and statistical laws, which are defined by Reiser as follows:

     This duality of natural law is stated in terms of contrast between dynamical and statistical laws. The first type, dynamical laws, are casual laws, giving rigid determination and predictability, and the second type, statistical laws, yield more probability and introduce indeterminism into the calculations. A dynamical or casual law eliminates contingency, and implies ability to visualize the mechanisms in operation. But in statistical laws, concerned with the calculation of mean values, the individual elements of the statistical ensemble are not studied… The atomic processes of microscopic mechanisms are reversible (sometimes periodically) and subject to necessary casual laws, whereas the macroscopic states represent the mean value of a large number of individual processes of a statistical aggregate…

     It is in this balance between dynamical and statistical laws that we find our margin of error in the application of homœopathic principles to our patients. The Law of Least Action is one of the dynamical laws upon which homœopathy was postulated and by which it has been affirmed. We acknowledge this law along with the Law of Similars and various other casual elements having to do with basic and cyclic action in natural processes, which in turn explain the processes of homœopathic action.

     It has been argued that if homœopathy is the application of natural laws, the results of our remedies should be uniform; there should be less variation in the details of provings; the length of action of any potency should be the same in all cases. No matter how careful the practitioner may be, he knows from bitter experience his failures, in spite of the most careful study and prescribing. There is no satisfaction in asserting that it is the failure of the prescriber; it is unsatisfactory to accept the statement that variation n living conditions may be the cause. We can allow a margin for hereditary tendencies, and again for psychic or other forces which we understand too little, that govern the threads of our life span; but beyond all this there are factors in the variation of remedy action that we are unable to understand. We may say that statistical laws authorize us to expect certain results from those dynamical laws which we attempt to utilize; that in turn these statistical laws presuppose conditions preexisting and perhaps unknown to us. But we may say, with more truth, that our incomplete understanding of dynamical laws causes us to assume statistical laws because it is a comfortable and convenient excuse; our danger here lies in practicing empiricism because of our dependence upon statistical laws.

     Certainly we know that we have a variable force with which to deal in treating the sick. On the other hand, we question whether we have not a variable force with which to deal in our remedies. If the impulse of a force is equal to the change of momentum produced by it, as we are told in physics, we prove the power of our potentized remedies after administration by the clinical evidence, in direct proportion to the production of symptoms on the healthy human being.

     Perhaps it is unfortunate that we have no measurable record of sickness or health per se. There is no determinable level of health. Our imperfect senses are incapable of perfect registration or infallible translation of symptoms. Our probability of error is doubled when we deal with another, the sick individual. We review our results by the clinical formula: The velocity of reaction is equal to the driving force divided by the resistance-unfortunately we cannot know with precision either the actual driving force or the resistance.

     Yet within certain limited fields we begin to measure the reactibility of the substances -animal, vegetable, mineral- that form the basis of our potencies. Elementary work of this nature has been carried on, but it is far from having been perfected. It is enough to recognize that within the atom lies the solution to the problem of reaction of the various potencies. This is like stating that the atom is in structure much like the structure of the universe, and that the composition of the atom, like the universe, is made up of a similar “solar system” with planetary revolutions in their orbits. We draw the analogy that the atom offers the solution to universal physics, and that the universe itself offers aid in understanding our specific problems. Surely this is a phenomenological view of the homœopathic field!

     Nevertheless, we suggest that these peculiarly pertinent questions are not elementary physics or chemistry; they partake of universal breadth and embrace our very reasons for existence.

     Consider again the question of potency. This has been a stumbling-block to many since Hahnemann’s development of potentization. Modern science teaches that energy is automatically thrown off in proportion to the weight of the atom; those of high atomic weight -radioactive- give off their own peculiar energy in proportionately high degree, destroying themselves in the process. If the atomic weight is lower, there is less intrinsic radiation and it becomes necessary to apply force to release the energy, until, in the low atomic weights more energy may be required to release the potential energy than thrift warrants, the erg unit being the expended effort and result. Yet for curative purposes it is probable that we might find the raw atom (as we may express it) entirely unfitted for our uses, and that the energy expended to break up the atomic structure sufficiently to release the electric, electromagnetic and magnetic orbits into malleable form for our purpose to be a sound investment of time and effort.

     Consider lime and its various material uses; consider how ineffective for physiological construction it is in its crude form, and indeed, how often it promotes rickets in children when introduced as lime water into the feeding formula. On the other hand, for countless conditions besides rachitic patients the homœopathic physician could ill afford to be without potentized calcium; and infinitesimal amounts exhibit astoundingly curative results.

     Recent developments in the study of the vitamins have demonstrated that in the lower triturations these become well-nigh inert, but by raising them to higher potencies in fluid form their activity and potent influence is markedly increased.

     This leads us to meditate upon the comparative value of trituration and succession as a means of stimulating the atom to a release of energy. It is impossible, of course, to attack the atom of lime by the same measures one employs to attack the molecular formation of plants. In some substances it is imperative to break down the bulk by trituration, while others are soluble in liquid and thus approach the state where the potential energy may be most readily release. If we were able to view the actual composition of the atom and its permeability, we might gain a fair idea of the reasons for energy release under different methods. This problem is allied equally to the construction of the atom and its destruction, with the result of wresting from it the greatest possible degree of its peculiar and intrinsic energy.

     In viewing our potencies, we find the statistical laws govern in materia medica when we casually assume that remedy provings in the lower dilutions will be applicable in equal degree and unvaryingly, in the highest potencies. Again, we assume that any potency, say the 200th, is always to be depended upon for uniform results, in spite of widely varying methods of development. To be sure, experience has taught us that certain remedies have certain symptoms, which are more or less fixed in all provings and which act with greater or less regularity -sufficient as a basis for statistical observations- when applied clinically. Herein lies our art in homœopathy, but just here we lay ourselves open to criticism as being the scientists we claim to be.

     Millikan tells us that under bombardment by alpha rays, an element may be built up to a higher atomic level; at the same time neutrons may be thrown off, as a by-product of artificial transmutation. “These neutrons are presumably constituents of all nuclei except hydrogen, and many nuclear transformations throw them out.” Neutrons carry no electrical charge, yet they are themselves weapons that may be hurled into atomic targets, making the atom unstable. This instability tends to step the atom down one degree and a proton-nucleus of hydrogen-flies out. Millikan tells us further that the neutron does not require great energy to get into a nucleus to transform it; if it does so with violence the result is to shatter the nucleus and thus produce several substances of smaller atomic weight than the struck nucleus itself. On the other hand, it tends to “fall in… more easily and oftener when they have slow speeds than when they try to force their way in with violence… In this way it adds its mass to that of the nucleus, so that the process results in the quiet building up of a heavier atom.”

     So far no technique has been devised to determine what the relation of trituration and succussion to energy release really means to the homœopathic preparation of remedies; whether we actually change the character of the elements with which we deal, and if so, whether or not this is in a fixed ratio, is a problem for the homœopathic physicist. This is a field not yet developed, but one that offers a challenge to homœopathy. Here is an open question to intrigue the mind of science, a problem that, if solved in its elementary aspects, would place homœopathic principles on a footing with the field attained by the foremost scientific pioneers in physics!

     Here we are faced with another problem in physics which has to do with the single remedy or polypharmacy. There is a reason for the single remedy even more profound than that practical one first advanced by Hahnemann and his followers: that since we know from careful provings what the single remedy will do, we can depend upon its uniformity (within certain limitations), but no one can predict the action of more than one remedy in combination or in alternation or in close proximity to each other. This is an observation, not an explanation.

     Modern physics may give us the solution in the “wandering neutron;” and neutrons are evidently loosed when certain elements of low atomic weight are combined even with an infinitesimal weight of radiations of an element of high atomic weight, and these neutrons in turn readily combine with other elements with which they come in contact; and while these elements of the third state do not necessarily become changed, they become unstable and again subject to further changes. Millikan quotes the case of “a bit of beryllium mixed with an infinitesimal amount of radium emanation…” where one of the neutrons released enters the nucleus of an atom of silver and thus raises the atomic weight of the silver one unit, the silver becoming extra heavy, still retaining its chemical properties, but becoming unstable and proceeding to throw out a negative electron and transforming itself into cadmium. To be sure, these changes were the result of experimental procedures, but we cannot be assured that any combination of elements might not produce just as profound changes, either constructive or destructive. This would be particularly true when we consider the methods we employ to release the inherent energy in seemingly inert substance. In our methods are sufficient to release energy we cannot be assured that they might not be transmuted.

     A further problem in potentization presents itself to our inquiring minds. If our methods are sufficiently practical to release these energies (and we must admit that the potential powers of our high potencies often startle us with their reaction) we may well inquire to just what degree the atoms of the elements are broken up in these substances. Unquestionably there is some definite ratio of energy release from the various elements, but to what extent trituration or succussion touches the atomic structure itself we do not know. If we could know that our application of force to these substances actually broke up the atom, we would recognize as a corollary that the destruction of the elemental atom and the consequent release of protons and neutrons tended toward the actual formation of different elements, with different atomic structures, and that these in turn had their own rates of energy which might be stabilized or unstabilized under certain conditions and combinations.

     This suggests further study of the composite substances, such as the plant remedies. It has not yet been demonstrated that living substance contains radioactive elements, but when we consider the implication of such experiments as those cited by Millikan we may question the reaction set up by breaking down elements of various atomic weights even in the lower registers and their interaction. Further, the reaction of these changing energies upon the molecular construction of the individual is something upon which we may ponder.

     Seemingly, these problems are beyond the scope of the physician. We feel impelled to know some of our materia medica and a few simple principles for the administration of our remedies. In other words, we naturally take a near-sighted view of our work. If we take the wider view -the phenomenological view- we see that these problems demand a more thorough understanding of our work; they express only a proper appreciation of our science and art.

     Even the United States Department of Public Health is recognizing the fact that there selenium is found near the surface -which occurs in only a few places in this country- the impaired health of the community makes continued habitation impractical and dangerous. Selenium ranks 34 in the scale of atomic weights, between arsenic and bromine, and falls considerably below those radioactive elements that have long been known to be dangerous neighbours.

     The series of aeroplane accidents on our Pacific Coast in 1936-7 has been attributed to the influence of uranium fields where the deposits approach the surface in certain places in California. Uranium is one of our very heaviest elements, number 92 in the scale; it is highly radioactive, and it is believed that these radiations disturbed the delicate instruments so they were useless, hence the tragedies occurred.

     Consider the patients with a heart condition, who cannot endure high altitudes. We recognize this important modality, and blood for the profound reason behind it. We are told that cosmic rays are five and one-half times as destructive at an altitude of 14,000 feet as at sea level. Cosmic rays are essentially destructive to all elements, especially the radio-active. Subjecting a patient hampered through his circulatory system, his vital balance already impaired, to forced known to be destructive might easily be fatal. It may be significant that these heart conditions often fall into the class of those conditions we recognize as being syphilitic or sycotic in origin (using syphilitic and sycotic in the sense of either the acquired disease or the inherited dyscrasia). The remedies applicable in these conditions, as we have pointed out previously, are remedies that in the majority are rated in the radioactive group.

     On the other hand, the patient who suffers from atmospheric pressure and the dampness of sea level flourishes at higher altitudes. We have previously discussed the problem of sycosis as a probable over-stimulation of growth and development of certain body cells. If this individual is exposed to increased bombardment by the cosmic rays, this tends to balance the diseased state, and the patient enjoys a more stable equilibrium.

     Here in the field of the atom lies the final answer to our questions of sickness and health -the problems of conception, growth, vital balance, decay. Here lies the answer to our problem of cure- maintenance of normal development, retention of vital balance, insurance against premature decay. This is a challenge to the scientist with an understanding of the homœopathic principles and their application, or to the homœopathic scientist who comprehends the phenomena of the structure of the universe. Not in a study of the individual sick cells, but of the universe and universal law, reflected in the universal structure of each elemental atom, shall we find our clarified view.

CHAPTER XXXII
HOMŒOPATHIC THERAPEUTICS IN THE FIELD OF ENDOCRINOLOGY

     The view point of the modern physiologist reflects the theory that the vast majority of human ills are traceable to dysfunction of the glandular system; that most growth problems (over and under-development of the whole body or parts) and many maladjustments of the child to its environment, and even of the adult to his relationships and problems, are related in some degree to endocrine imbalance. The modern student of homœopathy may have learned to scoff at the philosophy of Hahnemann, yet how close the endocrinologist’s findings are to the teachings of Hahnemann -that the human being is a unit, mind, body and spirit- and that these are so correlated as to act freely and without impediment when the vital principle, the spirit-like force or dynamis, is in equilibrium; yet if this equilibrium of health be thrown out of balance by the dysfunction of one member (or if this imbalance be manifest by the dysfunction principally of one organ) the whole is affected to a greater or less degree.

     So it is, also, that the function of some of the ductless glands is to secrets a minute quantity of specialized product into the system, a secretion that has a vital bearing on the health of the whole constitution. In many cases this secretion of a normal gland is so minute that it approaches the homœopathic attenuation.

     With this concept of the importance of the endocrine glands in maintaining health, and with the almost infinitesimal amount of some of these glandular secretions, we can hardly fail to see the important relationship the homœopathic remedy may hold to the manifestations of endocrine dysfunction and to the balance of the ductless glands themselves.

     In considering this vast subject it is apropos to quote from the book by August A. Werner, M.D., F.A.C.P., entitled Endocrinology (Lea & Fobiger, 1937):

     There has been much complaint from physicians in general that the literature on endocrinology is technical and difficult to understand. There are several reasons for these seeming difficulties, among which may be mentioned (I) the newness of the subject; (2) the lack of definite information as to the possible number of hormones and their functions; (3) the intricate inter-relationship of the secretions of the ductless glands; (4) the difficulty in application of the results of animal experimentation to the human, which, aside from the scientific value of such work, is the ultimate object of these investigations; (5) the variation of potency of the hormonal preparations used, and (6) the difficulty of determining individual dosage, which is influenced by the degree of function of the glands of the patient, the individual susceptibilities of the patient, cellular receptivity, interaction of other endocrine secretions, and the effect of general metabolic factors and disease processes in each individual.

     To be a good clinical endocrinologist, one must first be a good internist, and the time is not far distant when, in order to be a good internist, one must be a good endocrinologist…

     It is necessary to have:

     1. A thorough knowledge of the anatomical structure and arrangement of the autonomic nervous system. Its division into two parts, viz. the parasympathetic and the sympathetic; and knowledge of the function of these two divisions which are diametrically opposed to each other when stimulated.

     2. Comprehension of the function of the endocrine glands, in so far as this has been definitely or reasonably established.

     3. The recognition that the intricate vital life processes of the body over which we have no control, such as the regulation of normal growth and development, the digestion, absorption, and assimilation of food and its release from the storehouse, such as the liver and muscles for the production of energy, the continuation of cardiac action and respiration at a normal rate, our sense of well being; all these and more, depend in great measure upon the maintenance of a delicate equilibrium between the two divisions of the autonomic nervous system.

     4. A knowledge that the maintenance of this functional balance between the parasympathetic and sympathetic divisions of the autonomic nervous system is markedly influenced by the internal secretions of the ductless glands which acts as governors ever it…

     There is a great glamour from the medical profession for information on treatment of endocrine conditions. Before we can treat any abnormal condition successfully we must first have knowledge of the syndrome and its etiology (here speaks the view-point of the orthodox school) and secondly, we must have potent preparations for treatment. Many endocrine syndromes have been recognized in the past before active principles were avail-able for treatment. This condition still exists and the possession of active hormones does not always insure that relief can be given, for obvious reasons. With the desire and urge to alleviate these endocrine syndromes, all manner of glandular preparations have been utilized, many of which are inert, especially when administered orally…”

     In closing his Preface Dr. Werner gives credit to various members of the profession who have been of great help to him, and speaks of one member with the following significant tribute:

     Where an understanding of the fundamentals of endocrinology was acquired, and the lesson was inculcated to study the patient’s condition with every conceivable relationship to disease in mind and not as an aggregation of glands.

     In his first chapter the author cites the influence of emotions, as well as the reaction of various drugs, on various functions, with the reflex action on the glands through the nervous system. His comments on the organs in sickness and health recall Hahnemann’s observations, but in this 1937 observation Dr. Werner does not achieve the practical application of Hahnemann’s logic and philosophy which seems so plain to us.

     However, even a brief survey of his work astonishes us with the wide range of syndromes which Dr. Werner suggests are caused by glandular dysfunctions or are influenced by glandular preparations. These conditions range from acne to hemophilia, from anemia to deformed and distorted skeletal formation in children or developing in adult life. This implies that a vast array, if not the majority, of constitutional affections are due to glandular dysfunction, and therefore we may assume that the constitutional homœopathic remedy will have its usefulness here in the light of modern knowledge just as it has had in the past when we did not realize the importance of a knowledge of endocrinology, but trusted to the totality of symptoms as our sure guide in prescribing.

     There is little doubt that the majority of cases of over-and under-development of tissues or organs such as adiposis, obesity, inhibition of or precocious development of sex characteristics (whether traceable to the pineal, pituitary or thyroid glands or the gonads), and changes in the skeleton formation such as may come from dysfunction of the parathyroid, are, in the language of Hahnemann, manifestations of the miasms, either inherited or acquired. It may be circumstantial evidence for the miasm theory that certain types of manifestations are found among certain peoples, just as the types of obesity which are found largely in the Hebrew race; for one might argue with equal weight that centuries of prescribed diet might have had its influence. Nevertheless, in many cases of glandular dysfunction we are able to trace like tendencies through a family history. Sometimes in a case where no such evidence is available we may find a history, or definite evidence, of venereal infection, very often reported as cured by scientific treatment.

     To the Hahnemannian homœopath, the lack of laboratory corroboration has little weight because he realizes that the miasm may persist after the organism has been suppressed, diminished or destroyed by treatments in the infected individual or by passing through successive generations.

     In any case, while the orthodox school works on the basis of the objective symptoms, merely recognizing as concomitants the subjective manifestations in accordance with Hahnemann’s logical development of the therapeutic principle.

     Such a book as Dr. Werner’s offers us the most up-to-date discussions on the pathology, etiology and diagnosis of these conditions, but there is little real help here in the therapeutic field. Let us turn to such a book for such information as we may glean from the modern authors and research workers, but let us turn to a study of our rich fund of materia medica and philosophy when we wish to help the patient toward cure.

     As an index to our cumbersome materia medica let us turn to our repertories with the constitutional symptoms of the sick individual in mind. Here we are not forced to trace the organ supposedly responsible for the manifestations in the patient-symptoms mental and physical-and by meeting the symptoms of the indicated remedy we shall be able to meet like with like, and with reasonable assurance we can test the homœopathic principle in these as in other cases.

     Of course it is necessary in these cases, as in all others, to consider the possibility of cure, as in all others, to consider the possibility of cure, just as Hahnemann taught. This is well summed up in the concluding paragraph of an editorial in the October 1938 issue of the British Homœopathic Journal, which we quote:

     In estimating the possibility of successful homœopathic treatment of deficiency diseases we must, of course, recognize that the action of drugs is by eliciting a response from a living cell; they cannot do this from those that are dead or restore them to life. It is of no use to attempt the impossible. But we should also recognize that no organ or tissue becomes suddenly destroyed, unless it be by trauma, and that there are all degree of failure of function, and if the failure has not gone too far it should be, and we believe it is, possible to restore it to the normal by the giving of the simillimum… To this end we need a deeper acquaintance with our remedies. We are using practically the same materia medica that we did fifty or more years ago. It requires no alternation, but it does need to be added to, not by the addition of more remedies… but by fresh provings to pursue the action of our drugs into the realm of modern physiological research, and especially their action on the endocrine organs. If we do not increase our knowledge of the capabilities of our drugs our homœopathic art will become static. It will make no progress.

     It was our purpose to suggest several rubrics from both the Kent and Bœnninghausen repertories that are peculiarly pertinent to the conditions we are studying, but when we were brought face to face with the widely varying array of functional symptoms manifested by these patients, it seems we can do no more than commend to you the repertories themselves, and advise the physician who wishes to cure his patient not to neglect these valuable adjuncts to successful prescribing. In other words, when a cursory glance at a modern work on endocrine dysfunction covers such a wide range of symptoms, it is impossible to limit the possible symptoms in even a few syndromes. Again and again we are faced with the conviction that we are dealing with what we have already long since learned to know as constitutional symptoms, and we cannot think of a few rubrics that might be useful without omitting others even more valuable. So we can only repeat: Learn the value of your repertory for reference work, and you will be well repaid for the time expended.

     Nor can we, in one brief paper, begin to consider the syndromes which we meet in daily practice, and which we recognize as having endocrine relationships. We may only sketch a few of these conditions with a very restricted consideration of suitable therapeutic measures; and we may briefly outline a few outstanding remedies having general influence on glandular structure.

     Probably the type of glandular imbalance we meet most frequently is diabetes mellitus. The accepted therapy is insulin, and it has a definite influence on the sugar output; yet few physicians pause to consider whether this treatment is curative or merely palliative-a substitution therapy. Recent experiments indicate that continued massive doses of insulin may result in an increase of sugar following an initial decrease; and that it may remain at a fairly high level so long as the insulin therapy is pushed. A case recently observed provided the interesting phenomenon of a marked decrease of sugar output when the patient was forced to do without her insulin for a few days; and that when she returned to a decreased insulin dosage the amount of sugar remained at a much lower level than while she was receiving massive doses. A series of observation on patients under homœopathic care would be valuable.

     We must remember that once insulin therapy is established, it tends to become necessary to the patient and there is little hope of establishing normal balance. Therefore it is more practical to begin treatment by the use of the homœopathic remedy, for we can always go to insulin later if this is necessary. We find suitable remedies for Sugar in Urine in the repertories, and most of the remedies listed are deep in action or are closely related to emotional states. The diabetic patient usually presents subjective symptoms that clearly indicate the simillimum, or he may be able to give a history of emotional shock preceding his present affection that will point the way to the remedy. It is possible that his symptoms are so clearly marked that the indications for a constitutional remedy cannot be overlooked, even though his remedy has not been proven to produce the sugar imbalance. In such case, if the patient improves on the indicated remedy, we are justified in adding it to those already listed, giving it a tentative clinical rating. If the general level of health is raised, even though the low sugar threshold remains the same, we may safely rely on the remedy which maintains general improvement, and not be too anxious over the sugar output.

     Recent research work has indicated the influence of the pancreas in peptic ulcer. There is probably no surgical condition which yields so readily to the homœopathic remedy and proper diet, if it is discovered before surgery is necessary to save life. These conditions usually present enough subjective symptoms to define the simillimum from the list of suitable remedies Kent gives; in this list, too, we find the polychrests to the fore, probably with the Kali’s, Lycopodium and Phosphorus leading.

     It is frequently the case that in exploratory operations the close prescriber finds evidence of ulcers healed under his earlier prescriptions-in other words, homœopathic prescribing has left its signature on diseased tissues.

     Another frequent exhibition of endocrine imbalance is the disturbances of the menopause. These patients give us a wealth of subjective symptoms. In fact, many of these women are so voluble that we cannot overlook that great leader among the many indicated remedies for this particular state in life-Lachesis. But a well-rounded symptom analysis may show us some other remedy to have greater applicability.

     Hyperæmesis gravidarum is a serious condition we meet occasionally. If this condition is met early enough and we can find the indicated remedy, neither surgery nor yet endocrine preparations will be required. In the July 1938 Homœopathic Recorder Dr. Allan D. Sutherland gives us the indications for Ars., Bry., Cocc., Colch., Kali c. (the sudden nausea coming on while walking and the sudden overpowering sleepiness after eating a mouthful or two); Nat. mur., Petr., Phos., Sulph., Verat. a. Many of us do not think so often of Aletris farinosa with its muscular atony and chlorotic history. We would add to Dr. Sutherland’s list the nosodes, Medorrhinum, Psorinum, Syphillinum and Tuberculinum, for consideration. Dr. Sutherland is careful to point out that this is but a brief list of the possibilities; but it is valuable as a suggestion of help in critical conditions.

     One of the most distressing conditions we have to deal with (and one we fortunately rarely meet) is enlarged thymus. In his discussion of this condition, Werner states his conviction that it is not the enlargement of the gland itself which causes the sudden death, but that this condition is concomitant to the influence of the vagus nerve on the heart. This indicates even more strongly the necessity for the constitutional remedy for the small child, and the physician must be keen in watching his development, for all too often the child is in apparently good health until attacked suddenly and without warning. Where cyanosis, suffocative attacks or other symptoms occur, however slight, a remedy may be found that will carry the child through to normal health. If the symptoms take an asthmatic tendency we have more assurance in selecting the constitutional remedy.

     In general practice we frequently meet children who are back-ward in mind and body. Here is a field where we are able to do remarkably good work with our remedies. The Barium salts are not sufficiently appreciated for such work, but the Calcarea group, Silica or Sulphur (to mention but a few) may be more clearly indicated. Even the Kalis and the Natrums are surprisingly successful when indicated. When the constitutional remedy is found, it is surprising how these children -under-developed, dull, stupid, unable to learn, perhaps nervous and high-strung- reach to normal development.

     Often these children are deceitful as well as backward; then we add Arg. nit. and perhaps Bufo to our list; and if they are convulsive children these remedies may be even more strongly indicated.

     A consideration of the mental and emotional states is our best indication for the simillimum. This is not as simple as to feed glandular preparations, perhaps, but it is less apt to throw other glandular secretions out of proportions, and the results seem to be generally better. And no man who has watched the action of our potencies can doubt their efficacy.

     To a large extent the remedies which come to mind as constitutional remedies of sufficient depth to influence these glandular conditions with their structural and nervous concomitants are our great polychrests, and many of these are from the same chemical base as the elements of the physical body -Sulphur, Silica, Phosphorus, Kali, Natrum, the Carbons. Then we find such remedies as Lycopodium, Nitric acid, and the major nosodes, of great use in these conditions. It is impossible, as well as dangerous practice, to name leading remedies for any pathological condition, and still more for any pathological condition, and still more for any functional disturbance; yet there are valuable remedies which have a wide range and frequent usage in our daily practice that are not so valuable in these conditions.

     In running over suitable rubrics for glandular conditions we find Pulsatilla conspicuous by its absence in many rubrics, and when it occurs it is in the lower ratings. On the other hand, we find Lycopodium is a leader. Lycopodium is one of the very few survivors from the first era of plant life, and it has changed very little in appearance. It has survived because of the basic qualities inherent in the development of all life, and probably, therefore, has a greater potential influence on organic functions.

     There is hardly an organ or function that is not influenced by that greatest of all polychrests, Sulphur. Even Hering noted its influence on such glandular conditions as were then recognized. We have spoken of its value in developing backward children. It is classical for its use in deep-seated affections resulting from the suppression of superficial symptoms. It has proven its usefulness in diabetes mellitus. We all know the classical indications for Sulphur; but in passing it briefly, we mention one function of Sulphur we may have occasion to invoke: that of stirring the organism to reaction when other seemingly indicated remedies fail to act, especially if there are recurrences of acute or subacute manifestations-where the patient moves toward recovery only to slip back repeatedly.

     Phosphorus resembles Sulphur in its fields of usefulness as in many of its symptoms, while being quite different in its classical constitution. Where Sulphur is indolent, Phosphorus is over-excitable, erotic in many manifestations and erratic in most symptoms related to the sexual functions. These manifestations range from insanity or lascivious ideas to vicarious menstruation, impotence and abnormal labors. Phosphorus affects the development of the physical body in the child, his ability to concentrate his mental efforts, and the normal functioning of the adult, just as in Sulphur. Prostrated energies from loss of fluids and from emotional and physical strain are characteristic of Phosphorus, as against the general lack of energy in Sulphur.

     Both Phosphorus and Phosphoric acid are to be considered in glycosuria, as well as other glandular difficulties.

     Nitric acid has a powerful action on glandular dysfunctions, especially of syphilitic origin, although it is antipsoric and antisycotic as well. Sensitiveness is a keynote of this remedy-of the head or of affected parts, to touch, jars, sudden motion or sudden change in tempo of motion; to cold, to changes in the weather; tendency to take cold. There is great disturbance of the circulation; the fingers and toes appear livid, pale, cold or dead at times. The characteristic sensation as of a splinter in the affected parts, particularly in such tissues as the tonsils, is found also in Arg. nit. and Hepar. In Nitric acid the disturbance of the sexual organs and functions rivals Phosphorus, and sometimes there is almost as much lasciviousness. In general the sensitiveness and excitability is uppermost, but they tire quickly; old people calling for this remedy manifest excessive prostration.

     ”Vegetable sulphur,” or Lycopodium, is one of the great trio of remedies (Sulphur, Calcarea and Lycopodium) about which, as Clarke says, “all the rest of the materia medica can be grouped.” Like the rest of the trio, it has swollen glands, and is one of the few specifically mentioned as having goitre. Acute glandular affections start on the right side and tend to move to the left. This is one of the few remedies mentioned in the materia medica as definitely tending to enlargement of bony tissue, whereas Phosphorus tends to thickening of bony tissue. Characteristically, Lycopodium has a furrowed face and forehead; thin face and neck and perhaps upper chest, while he remains plump below, or there is progressive emaciation from above down-ward. Great weariness and lassitude, especially in the legs after slight exertion, and great want of bodily heat; deadness of the fingers and hands as in Nitric acid; he feels as if circulation were suspended. Mentally he is as Phosphorus and the Kalis, as sad as Nitric acid and the Natrums; the burning pains make us think of the burnings of Sulphur and Phosphorus. Probably Lycopodium is the most flatulent remedy we shall consider, unless it be Carbo veg., which has more heartburn.

     The general state of gloominess and mental depression characterizes the Natrum group and it their great earmark in chronic states; they almost delight to make themselves and others miserable by looking on the dark side; strong aversion to consolation; sometimes alternate gaiety and gloom.

     These salts are a startling exposition of the power of potentization, for in this form they have the most profound action on the mental state, on physical functions, on the chemistry of fluids and the pathology of the organs. There is sudden failing of strength, excessive draining of body fluids coming on suddenly, sudden depletion of the sexual organs because of excessive stimulation; rapid changes in the blood; sudden and profound emaciation, often following previous increase of flesh. Nat. mur. particularly, emaciates about the neck, even when eating ravenously. This group of remedies affects the thyroid gland markedly, and has the subjective sensation of compression, as if there were a lump or plug in the throat. Nat. ars. has the sensation as if the thyroid body was compressed between the thumb and finger. Nat. carb. has the hard swelling of the thyroid.

     Clarke tells us, in his Dictionary, that Nat. carb. gives the type of the family group, while Nat. mur. is the most important remedy of the group, ranking with the polychrests.

     These remedies are exceedingly sensitive to cold: Nat. carb. is the chilliest; it cannot stand cold air, draughts, cannot stand a change of clothing or a drink of cold water because of the chill; yet Nat, carb. is unable to stand the heat of the sun and succumbs easily to heat stroke. He has no physical stamina; he exhausts quickly from mental or bodily exertion, and suffers great debility. Like the family, he is profoundly exhausted after a short walk, and Nat. carb., particularly suffers from the effects of overstudy. The nervous system is weak yet is easily affected almost to hysteria, just as in the sexual sphere there is sterility because of over-activity of the organs.

     Other outstanding manifestations of the exceedingly sensitive state of the nervous system is the extreme sensitivity to music and the aggravation therefrom, and the aggravation before and during electrical storms. Like all the Natrums, there is anemia with an increase in the white cells and decrease of red cells; with this there is emaciation and bloating. Children find walking difficult because of even weaker ankles than in Sulphur; they are disinclined to study because it is so exhausting; nervous almost to hysteria; pale, weak, easily tired, easily chilled; they bore their fingers into ears and nose and it seems to relieve. The adult Nat. carb. patient shows much the same picture, but if a man, he tends towards priapism; if a woman, there is a discharge of mucus and the semen after coition with consequent sterility; if she goes on to gestation, labour pains are weak and ineffectual and she begs for massage. The Nat. carb. patient is always spraining a wrist, an ankle, a knee, dislocating a joint or straining a muscle in the back.

     Nat. hypochlorosum is distinguished from the others of the family group by its rapid emaciation with a sudden, waterlogged uterus which sags into the lower pelvis with the sensation as if it would fall out; with this there is almost a globus hystericus which seems to rise from the uterus into the upper chest. Faintness, weakness and weariness, so that she falls asleep whenever she sits down, with flabbiness and a diffused hydrogenoid condition with a tendency to leucocytosis mark this remedy.

     It is difficult to confine oneself to a brief outline of Nat. mur. Clarke tells us that it corresponds to that type of constipation which is associated with anemia, chilliness (especially down the back) and cold feet; or to indigestion in masturbators. The degree of melancholy keeps pace with the constipation, just as in Nat. sulph. the melancholy keeps step with the degree of indigestion.

     Tears are a keynote of Nat. mur.: tears with the emotional depression, tears even with the laughter, for she laughs until she weeps at things not at all funny; tears with the coryza, and even with the whooping-cough. The face is earthy, dirty and greasy. The strong desire for salt is even more marked in the nausea and vomiting of pregnancy. In adults suffering from glandular imbalance, with a history of malarial fever and the classic dosing of quinine, Nat. mur. may unlock the case and even carry it to cure. The Nat. mur. child is slow in learning to walk and talk, craves salt so that he will eat it as some children do sweets, and when out of doors is apt to eat earth. We are told that Nat. mur. is the chronic of Ignatia; certainly the emotional Natrum family shows the effects of emotional strain or shock as much as Ignatia and Ignatia by the way is a remedy we often overlook in diabetes following emotional shock.

     Nat. phos. children develop improperly because of excess of lactic acid in their diet. It merits wider use than it has received, and its general features are marked by the parent sub-stances. Like Phosphorus, it is effective in diabetes, but here it shows its relationship to the Natrums, because this diabetes is apt to be a reflex of hepatic derangement. There is much disturbance of the sexual organs; there is weak back and trembling limbs, especially knees, after coition and after the nightly involuntary emissions. Instead of the weak, lax muscles of Nat. carb. we find here a tension of muscles. There is inability to apply himself to his books, and even the effort causes despondency.

     Nat. sulph. is unusually gloomy, even for this gloomy family. It is strongly hydrogenoid in tendency; there is marked aggravation from water and dampness; he may be so sensitive to this that he cannot eat food grown on wet ground; he cannot live with comfort near a body of water. Nat. sulph. has less influence on goitre, perhaps, but there is the sense of constriction in the throat that foreshadows its usefulness in this field. It has marked usefulness in the enlargement of the liver and spleen and is almost as useful in old malarias as Nat. mur. It is particularly valuable in glandular imbalance following injuries to the head; in fact, it is almost a specific for head injuries, even long after the trauma. It has profound action on the blood, and it has proved its usefulness in leukæmia.

     In his Dictionary Clarke lists twenty-one Kalis, the majority having been well proven. T. F. Allen said the Kali salts were insidious in action and destructive of every organ and tissue in the body, so it is natural they are frequently indicated in glandular dysfunction.

     No doubt the predominant action of the group is anti-syphilitic. There are the manifestations of primary syphilis, ulceration of mucous membranes, even destruction of bony structure as in the nose, as well as other symptoms of the miasm. On the other hand there is the marked sycotic trend as shown by the catarrhal discharges, and it has a field in acute gonorrhœa.

     The chronic Kali patient exhibits the classical stature of the sycotic-rather short than tall, chubby to obesity, and with an accompanying anemia. Here we have the perfect field for homœopathic therapeutics in endocrine imbalance, for there is a wealth of characteristic mental symptoms varying from the dull mentality with loss of memory and inability to exert the mind, even to softening of the brain, through all the states of nervous excitability (with or without intelligent co-ordination) to the high-strung nervous patient who borders on insanity or is actually insane. These people are easily startled at the slightest noise; fearful, apprehensive, expect to die shortly and fear death. They may be as sad as the Natrums at times, but they are even more fearful. The Natrums have aggravation from mental exertion, but the Kalis cannot concentrate enough to bring on an aggravation.

     Clinically, the following brief summary suggests fields of special usefulness in glandular dysfunctions, and indicates further study:

     Kali aceticum in diabetes. Kali arsenicum for exophthalmic goitre. They are quarrelsome, discontented, jealous; the mental symptoms recur every third day.

     Kali bromatum and Kali phos. are the most mentally degenerate of the Kalis; both have developed softening of the brain in their clinical picture. Both remedies have done good work in the backward children and the aged. In the adolescent Kali brom. is often useful for acne appearing at that period. Kali brom. is useful in diabetes; emissions, impotence and masturbation; and in women, affections of the ovaries, Kali brom’s peculiar mental symptom is that, when walking, he is sure he cannot pass a certain point ahead of him.

     Kali phos. has marked flushing, especially in young people-they flush and pale because of nervousness and it aggravates the nervous strain. There is marked anemia; disturbance of the menstrual function; atrophy of the male organs; nymphomania. Sexual excitement, either indulged or suppressed, aggravates all symptoms.

     Kali carb. is such a polychrest that it is difficult to limit it to a brief citation without omitting salient points. However, it is marked by such a great weariness that she wants to lie down, even in the street. It is exceedingly useful in the menopause, in disorders of pregnancy and in disordered menstrual functions. It is anemic and obese, with atony of the muscles.

     Kali ferrocyanatum deserves a wider use than it has received. It was well proven by Bell, who found that “it rivals Sepia in the uterine sphere.” These people are chlorotic and debilitated; they suffer from dysmenorrhœa, dyspepsia and fatty degeneration of the heart-an exemplification of Allen’s estimate of the family.

     Kali iod. is one of our great goitre remedies and it also has atrophy of testes and mammæ. Life seems insupportable to this patient; he awakens at night to dread the return of dawn.

     Kali mur. is the outstanding member of this family for swollen glands; in fact, swelling is one of its characteristics, for it is very useful in swellings following blows, cuts and bruises. It may be indicated in glandular troubles following vaccination, and in Hodgkin’s disease. The Kalis tend to white mucous surfaces, and Kali mur. is perhaps the most marked for this symptom.

     Silica has such a vital relationship to growth, development and functions of mind and body that it is difficult to limit our view of it to brief mention. It affects the development of the bony structure and teeth, and is useful in knitting tissues after operation or trauma, or in removing keloid or abnormal scar tissue. There is profound action on the blood, and this, together with its affinity for glandular swellings, is the key to its suppurative tendency. A weak spine, brain fag, feeble circulation, caries, abscesses and fistulas, hernias and even hydrocele, give some idea of its depth and breadth of action. This is one of the few remedies listed as clinically useful in elephantiasis. Remember that vaccination or suppressed foot sweat may be the cause of your Silica condition, and that your Silica child is the classic problem “angel child.”

     The Calcarea group should be studies in these conditions. Calcarea carb., especially, has a strong resemblance in the childhood symptoms to Silica, but where Silica has the suppurative tendency in glandular symptoms, Calcarea’s tendency is to indurate. Calcarea is apt to be pot-bellied; but there is the same depraved appetite as in Silica, a like relationship to growth and development of the teeth and bony structure, and as much anemia, and even more spinal affections. It has the weak ankles and the child walks late; the child is fat, rickety, pale, and sweats profusely about the head. Calcarea’s sexual organs are greatly disturbed functionally, while Silica’s sexual organs are apt to be more disturbed by pathology. Calcarea is the corpulent adult with full, even pendulous, abdomen and goitre or renal calculi.

     We should remember the carbons -Carbo veg., Carbo an., Graph., Sepia- in glandular conditions. The major nosodes merit further study along these lines, also. In fact, all our polychrests and many of our near-polychrests will yield richly to our search for effective remedies in endocrine disorders.

     As homœopathic physicians, we have undertaken a labour that is vast in its expanse, yet it yields to us in the degree to which we apply ourselves in its pursuit. Our resources are far greater than those of the orthodox school; we have proved them to be potent in a varying range of attenuations to suit best each man’s experience and requirements. Our remedies will not upset the balance of endocrine secretions, for the simillimum will fill the demands of the system in all its parts without stimulating too much those organs which have maintained a relatively secure balance. In other words, our remedies affect directly the vital energy which in itself established equilibrium, those parts which are susceptible because of imbalance becoming a part of the normal healthy functioning of the whole unit.

     Let us watch with great interest the investigation of the endocrine system but let us look with the expectant eye of the explorer upon our homœopathic remedies, that we may meet and cure even these little-understood conditions.

CHAPTER XXXI
DISEASE CLASSIFICATION: A SUMMARY

     Let us summarize the different stigmata, remembering that we may get all shadings of all the stigmata in their groupings in our patients, but one stigma will predominate above all the others. They all have their characteristic differences. The accentuation of psora is function; the accentuation of the syphilitic taint is ulcerative; the accentuation of sycosis is infiltration and deposits.

     When suppressed, the syphilitic stigma spends itself on the meninges of the brain, and affects the larynx and throat in general, the eyes, the bones and the periosteum.

     Psora spends its action very largely upon the nervous system and the nerve centres, producing functional disturbances, which are > by surface manifestations.

     Sycosis attacks the internal organs, especially the pelvic and sexual organs. In this stigma we find the worst forms of inflammation, infiltration of the tissues causing abscesses, hypertrophies, cystic degeneration; when thrown back into the system by suppression this stigma causes dishonesty, moral degeneracy and mania.

     In treating patients suffering from these stigmata, this classification is of inestimable value, for it immediately throws the simillimum into a class of remedies corresponding with the accentuation of the stigma that is outstanding in the case, and this should be considered in the totality; it will often throw light upon the choice of a simillimum that is applicable to the individual case and stage of development.

     When we are considering a case manifesting mixed stigmata, there is always one more prominent, and this will be the one requiring relief; when this is relieved, the next in prominence must be cared for, until the patient is freed from the inheritance of generations.

CHAPTER XXX
SYCOSIS-OVER-CONSTRUCTION

     WHEN we come to analyze the sycotic miasm in relation to the table of elements and their respective atomic weights, we find an entirely new grouping of symptoms. We have stated in the summary of the miasmatic symptomatology that the psoric manifests most strongly the functional symptoms; the syphilitic has as its hallmark ulceration and destruction of tissue, even to bony tissue; while the sycotic has an opposite manifestation-infiltration and overgrowth of tissue.

     Therefore we see that the sycotic stigma presents a problem in physical construction that is the exact opposite of the psoric, granting that our theory has been so far sound. Thus, while the psoric patient is unable to assimilate sufficient elements from sunlight, air, water, food, etc., for well rounded physical structure in which to house a normal healthy mind and spirit, we find that the sycotic patient is too susceptible to the available constructive elements; he seizes upon and assimilates to the point of overgrowth of tissues. If this is so, it explains the reason for pathology in all parts of the body that manifest overgrowth of natural tissue; and we have already noted that where we find malignancies with overgrowth of tissues and infiltrations we are almost always able to trace the sycotic taint.

     Consider the necessary elements for physical construction and the lavish manner in which they are supplied by Nature in fresh air, sunshine, fresh fruits, vegetables, nuts, even in fresh sea food and animal tissue which we adapt for food. In the case of manganese, for instance, McCollum tells us that but a small amount is required in our daily food, but that it is very difficult to prepare a diet entirely free from the element for experimental purposes. If it is so difficult to prepare food and omit the small amount required, what an excess of the substance must be available in a normal diet. Yet the healthy normal system absorbs only the amount required to maintain a state of health.

     A list of antisycotic remedies has been complied from several standard works on materia medica; we shall give a list excerpted form this, comprising only those remedies with a primary chemical relationship. It will be noted that almost all these remedies fall within the group of body construction elements; but it is significant that the so-called “double salts” predominate. Another interesting fact is that the carbons are almost entirely lacking, while the Calcareas appear infrequently. Chemical combinations of the very lowest elements are found to be fairly frequent, as in Fluoric acid, Nitric acid, Ammonium mur. It is interesting to note that while there is a preponderance of the Kali’s, Kali carb. is omitted. It will be noted, too, that while Aurum mur., Baryta mur., Cinnabaris, Mercury and Plumbum appear in this list, the first three are tinctured with elements of a much lower atomic weight, while the two last are comparatively rarely indicated in true sycotic conditions unless there is a syphilitic taint as well; although of course these might be indicated when the condition approaches disintegration of tissue as toward the final chapter of the disease. Let us examine these remedies, comparing their relationships by number to the elements.

     It is not to be thought that these remedies, even with those form animal and vegetable sources added, are all that might be indicated in sycotic conditions; but these show the trend of the remedies that are most likely to be indicated. It is an accepted fact that all plant remedies contain the constructive elements, rebuilt into potential and varied combinations in every species of plant life. So too our animal remedies have their value only in what has been made of the elements assimilated and rebuilt. It is this reconstruction that gives their potentiality.

     However, in the association of elements with the remedies under consideration, we note a greater proportion of those containing chlorine (17) than any other element. Further, we note a gap between Bromine (53) and Argentum (47). In order of atomic weights the following fill in this space: Krypton 36; Rubidium 37; Strontium 38; Yttrium 39; Zirconium 40; Columbium 41; Molybdenum 42; undetermined 43; Ruthenium 44; Rhodium 45; Palladium 46. Of these Strontium and Palladium have had considerable provings, and both have been found useful in sycotic conditions. However, Strontium is found in natural association with Plumbum, and its greatest influence, homœopathically, seems to lie along similar lines. Palladium and Rhodium (the latter has had a brief proving) are associated in their natural state with Platinum; the latter being in the higher register of atomic weights, we consider as being more particularly in the destructive classification. However, Cadmium (48) is a remedy to be considered in this antisycotic group, particularly in pathological end product.

     Some of the elements that come within the range of the constructive group, yet which have never been defined as having constructive roles, have been detected by the spectrograph in milk; these are: Barium 56; Boron 5; Lithium 3; Rubidium 37; Strontium 38; Titanium 22; Zinc 30; also, by other investigators, Aluminium 13; Chromium 24; Lead 82; Silicon 14; Tin 50; Vanadium 23; Manganese 25. These are by no means all the inorganic sub-stances contained in milk, but are those that have been detected only in traces, and their constructive duties have not been defined.

     Detection of these elements is of particular interest in that it suggests roles of some sort to elements heretofore missing in our constructive elements; and because of its inclusion of Barium and Lead, the latter being so far beyond the constructive limits as we have understood them. Moreover, these elements, associated with physical functions of the body (albeit in animals) leads us to inquire why elements of such high atomic weight should appear in nutritional functions? Was this by chance, some imperfection in technique on the part of the investigators, or have we a still wider field beyond that compassed by our present knowledge and the hypothesis founded thereon?

     These comments upon the remedies frequently associated by symptomatology with the problems of hereditary or contracted disease taints must be understood to be no more than the first uncertain steps toward a newer understanding of the relationship of our potentized remedies to cases that may present themselves before us. We realize it is far less important to rationalize the REASONS FOR than to embrace a knowledge of the means to CARE FOR these conditions; but while these suggestions of the possible modus operandi of a certain group of elements are extremely rudimentary, it is hoped that the problems involved will be clarified by more study to the point where here, too, we may verify the whole process of logical reasoning and scientific procedure that has made homœopathy THE profoundly coherent system of healing.

CHAPTER XXIX
DISEASE CLASSIFICATION: SYCOSIS

     SYCOSIS is generally understood to be the gonorrhœal poison. We should make the distinction clear between gonorrhœa and sycosis. Gonorrhœa is the acute infection of the gonococci, which takes from five to ten days to develop a urethritis after an exposure. During this incubation period it is purely an infection; then the local manifestations are thrown outward by Nature at the point of attack as a resentment of the vital energy to the infection. If the gonorrhœa is thoroughly and completely cured, practically no sycosis ever develops. Sycosis is established after a suppressed gonorrhœa, when the acute infection is driven in upon the vital energy by external methods of suppression, and it then becomes a systematic stigma, permeating every living cell of the organism, and transmitting its deadly destructive forces to the offspring as well as retaining the full destructiveness of its power in the original individual, and impregnating the mother of the child.

     The suppressed gonorrhœal infection is very apt to first show itself in attacking the blood and producing an anemic condition, and a general catarrhal condition is set up. Oftentimes an inflammatory rheumatism develops; inflammation follows in the soft tissues, and changes in the fibre of the muscles. In fact, the whole organism becomes involved. Sometimes a stasis develops in the lymphatics; there is a swelling in the groin following the suppression and inflammation in the prostatic gland.

     These are the symptoms that are first produced after a suppression, showing that the whole organism is involved and in the grip of this destructive force. Seldom do we get these constitutional symptoms when the initial gonorrhœa is cured by the homœopathically indicated remedy, and if there is any constitutional taint, it is in a mild form.

     The transmission of this gonorrhœal poison, or sycotic poison, as the case may be, is transmitted in the stage into which the infecting individual has arrived. If it is a true gonorrhœal infection, true gonorrhœa will be transmitted; but if it has reached the secondary stage (which usually comes on three months after the first stage has subsided, and may be delayed a full year) the contracting party will develop the condition at the same stage as the infector.

     The secondary and tertiary symptoms of sycosis can be entirely eradicated by homœopathic treatment.

     In the secondary period of sycosis almost every disease that may arise takes on an inflammatory nature in some form; it may be acute, subacute or chronic, and it may vary from very mild to very malignant fevers.

     We know how frequently we see cases where soon after marriage a perfectly healthy, robust girl begins to droop and becomes ill. This is because the secondary symptoms of sycosis have been transmitted to the extensive mucous surfaces of the female organs. Oftentimes it is a single organ that becomes involved, like the ovary with its cystic manifestations, or a fallopian tube manifests inflammation; again they may show a very anemic state of the blood and when this anemic condition arises it affects every part of her organism, coming on gradually, slowly, until her whole system is permeated. She becomes pallid, drawn, puffy; there is no stamina to the muscles. The anemic condition arises from this stigma because sycosis destroys the red blood cells through imperfect oxidization of food.

     This may be a forerunner of carcinomatous conditions of the breast or uterus; diabetes, Bright’s disease, or numerous other diseases of this type, largely dependent upon previously existing taints in her own system. Sycotic manifestations are characterized by slowness of recovery; the subject is constantly slipping backward because of the destructive character of the stigma, whenever he gets an acute manifestation.

     The sycotic patient is exceedingly suspicious. The suspicion extends to the point where he dare not trust himself and he must go back and repeat what he has done or said, and wonders if he goes back and starts again. He is suspicious that he will be misunderstood, that his hearers will give the wrong meaning to what he is attempting to convey. This suspicion, when turned upon others, leads to the worst forms of jealousy of his friends, for he knows full well that he is not understood. The sycotic taint develops the worst forms of degeneracy because of the basic suspicion and jealousy, patients will resort to any and all means of vindicating themselves in stigmata, in its suspicion, its quarrelsomeness, its tendency to harm others and to harm animals. This produces the worst forms of cruelty and deceit and the worst forms of mania of any of the stigmata.

     The sycotic patient is cross and irritable; he is absent minded in certain things, and finds difficulty in getting the right word; the more he looks at the word after he has written it the more strange it seems and the less confident he is that it is right. He forgets recent happenings, but remembers distant events very clearly. Sycosis like the syphilitic stigma, has the mark of self-condemnation, which is the moral reaction to the inception of the disease state.

     Here, too, we find the fixed ideas as in syphilis, and in the union of the two stigmata these characteristics are much more marked; there is also the same slow mental power. The sycotic is disposed to fits of anger, and when the syphilitic taint is also present these people present the picture of the sullen, smouldering type that threaten to break out into dangerous manifestations. Sycosis, coupled with psora, is the basis of most criminal insanity and of most suicides; degenerates are sycotic or syphilitic, or result from the combined destructiveness of the two stigmata.

     When some external manifestation occurs, such as a catarrhal condition, a leucorrhœa, or even the return of the menstrual period, there is a general amelioration of the mental condition. The mental condition may be much when wants or fibrous growths appear; they are always > in general from the return or breaking open of old ulcers or old sores, and markedly > by the return of acute gonorrhœal manifestations. Pains often alternate with the leucorrhœa. While there is much amelioration by eliminative processes natural eliminations, such as diarrhœa, free urination, or even perspiration, does not ameliorate.

     All the miasms, of stigmata, have many head symptoms. The headache in the vertex is sycotic in its origin; or there may be frontal headache. These are < lying down and at night, especially < after midnight. There are feverish headaches of children. This patient is restless and wants to be kept in motion, which >. The head symptoms resemble the syphilitic in that they have the night aggravations, and there is the same type of vertigo at the base of the brain.

     The hair falls out in circular spots; the hair of the beard falls. The sycotic scalp perspires, but there are not the moist, matting eruptions of syphilis.

     Sycosis never gives a true ulcer; the sycotic manifestations are more overgrowth of tissue than destructive of tissue. There are many warts and warty growths; these are sycotic signposts. Moles and papillomata may be either syphilitic or sycotic. Deposits of gouty concretions characterize this stigma.

     Arthritic troubles of the eye are a combination of sycosis and psora; there are also neuralgias which are < on change of weather, < change of barometer, < rainy weather.

     The sycotic usually has a red nose with prominent capillaries. The sense of smell is lost. Children with “snuffles” are usually syphilitic or sycotic; the sycotic stigma has moist snuffles, but without ulcerations or crusts; the discharge is purulent, scanty, with the odor of fishbrine.

     The fishbrine odor is characteristic of the sycotic taint, and it may appear in all the discharges, but especially in the discharges form the genital tract. The sycotic discharges, like the tubercular, are greenish or greenish-yellow.

     There is often nasal stoppage due to thickening of the membranes and to enlargement of the turbinated bones. Except in acute colds the discharges are scanty. The slightest amount of discharge, however > the patient.

     Hay fever conditions, which are exceedingly difficult of cure under ordinary treatment, are more easily understood when we remember that they are an expression of syphilis and latent sycosis, very often with a psoric taint. Erysipelas is a combination of he psoric and sycotic stigmata.

     The sycotic patient is especially liable to rheumatic troubles, and where this taint appears, especially if there has been any attempt at suppression of the rheumatic manifestations, we find reflex troubles in the heart, with violent hammering and beating.

     In the combination of sycosis and psora we get the right soil for valvular and cardiac disturbances with changes in the organic structure; these are the conditions that cause the fatalities. With these sycotic heart conditions there is none of the fear and apprehension that we find in the psoric patient. The syphilitic and sycotic heart conditions are much more dangerous than the psoric, but the psoric patient worries about his condition, takes his pulse frequently, fears death and remains quiet, while the syphilitic and sycotic patients have no mental distress, and may have no subjective heart symptoms; but they die suddenly and without warning.

     If there are pains about the heart and dyspnœa, these conditions are > from gentle exercise, as show walking or riding. When there is any trouble about the heart in sycotic patients there is usually some dyspnœa. When the heart condition is of rheumatic origin, however, there is sometimes severe pain, very much < by motion. These patients have a soft, slow, easily compressible pulse; the valves are roughened, the muscles become flabby and soft, and in long-continued cases they lack power. As a rule these patients are fleshy and puffy; their obesity is the cause of their dyspnœa.

     Frequently the face becomes bluish and cyanotic, sometimes with venous congestion. The cyanotic condition in these patients is not painful. The anasarcas never become very extensive, because these patients die before the anasarca has time to manifest itself to any degree; they snuff out like a candle. These conditions are very much < by high living, rich spicy food or spirituous liquors.

     Meats arouse the latent sycosis as in psora. The sycotic patient should take meat sparingly, and it is better for him to use more freely of nuts, beans or cheese. Gouty conditions cannot digest meats. He craves beer, and while this is not a desirable element of his diet, it causes much less < than do wines.

     He is usually < by eating any food, and > by lying on the stomach or by pressure.

     His taste is musty of fishy. His pains are always colicky in nature, especially in the abdomen, and they are > by bending double and by hard pressure. In fact, we hear of his colic so frequently that we get tired of the story. There are occasional diarrhœas, but always preceded and accompanied by the colic, griping and tenesmus. The stools are gushing and ejaculated forcibly. The colic and stools of Rheum., Cham. and Mag. carb. are typical of this stigma. The colicky manifestations make the patient irritable. All bowel and intestinal troubles of sycotic origin have the constant symptom of colic, whether it be in the diarrhœa, the hemorrhoids, or any other digestive manifestation; and with this there is always the marked irritability.

     The sycotic child is sour-smelling in all ways; even the stools smell sour. He wants constant attention; he must be rocked or carried; his colics are > from lying on the abdomen or from pressure. Dulcamara is typically sycotic in its manifestations; it has the diarrhœa, acrid and corrosive; from getting wet; bleeding hemorrhoids with great pruritus; fishbrine smell.

     In the urinary tract there are many symptoms. There is intense pain on urination; children scream from the pain. This is due to a spasmodic contraction affecting the urethra. Many diseases of the urinary tract are combined syphilis, psora and sycosis, with the last two most prominent. The diabetic patient is usually strongly tubercular, but if there is a sycotic taint as well, the condition becomes much more malignant. Bright’s disease is a manifestation of all three stigmata combined. Where we find fibrous changes we may be sure there is a strong sycotic influence.

     In the rectum we find many conditions of tubercular origin, as strictures, fistulæ, sinuses and pockets, but when there is the addition of the sycotic stigma the conditions are greatly aggravated, and there is much more tendency toward malignancy, for combinations of he tubercular diathesis with sycosis produce cancerous affections.

     In acquired sycotic conditions represented by prostatic gland troubles there is a combination of all three stigmata.

     The most frequent location of the sycotic manifestations in women is in the pelvic organs. Pelvic inflammations such as inflammation of the ovaries, inflammatory diseases of the female pelvis may be traced to this taint. In the more chronic types we get cystic degeneration of the ovaries, the uterus and the fallopian tubes. Again, the infection may pass on into the peritoneal cavity, and we find general peritonitis and general cellulitis. Appendicitis is directly traceable to sycotic influences.

     To distinguish the sycotic manifestations in the abdomen, bear in mind the colicky, spasmodic and often paroxysmal pains of sycosis, the acrid discharges which corrode the skin; the stale fish or fishbrine odor of the discharges; the mottled appearance of the mucous membrane.

     The attempt to suppress sycotic manifestations, especially the discharges, is very common medical practice; but suppressive measures meet with a very prompt and decided renewal of the stigmatic power and energy. After such an attempt, the destructive progress of the disease becomes much more rapid, and often seen in the disturbances of the sexual organs which lead to surgery as a way out of the difficulty, and immediately after operation, when the physician has reason to believe his patient to be on the road to recovery, there will be a sudden flaring up of the difficulty and death ensues very soon. When such a series of circumstances occurs, it is unquestionably because of the sycotic influence that may have been more or less unnoticed in the patient’s condition. Often there is such a sequence of events after some injury.

     Sycosis, continuing the gonorrhœal poison in its chronic state, has the rheumatic conditions that we may expect. There are tearing pains in the joints, which are < during rest, < during cold damp weather, > moving or stretching, > dry weather. There are pains in the small joints with infiltrations and deposits. Stiffness, soreness and lameness are characteristic of this stigma. The troubles in the joints, where there are deposits of lime salts as in arthritis deformans, are sycotic. The gouty diathesis has a sycotic base.

     The sycotic skin manifestations tend toward overgrowth or extra deposits. The nails are ribbed or ridged and thick and heavy. Moles, warts, wine-coloured patches and other manifestations of unnaturally thickened skin belong in this classification. Skin eruptions of this stigma occur in circumscribed spots, and there are exfoliating eczemas. Psoriasis is a combination of the three stigmata, with sycosis and psora predominating. The fishscale eruptions are also a combination of the three stigmata, with the dryness of psora, the squamous character of syphilis and the overgrowth of tissue, or the thickened skin manifestations, of sycosis. Herpes zoster has a sycotic base. Malignancies of the skin are more violent and intractable in proportion as the sycotic taint is increased. Barber’s itch readily develops in sycotic patients, while it rarely develops unless there is a sycotic taint.

     We have all noted the tendency of some operated patients to develop stitch abscesses. This never occurs unless there is a sycotic tendency in the patient.

CHAPTER XXVIII
SYPHILIS

     WE have spoken of the psoric miasm as being closely related to the deficiency disease, so called. Now on the same basis of the table of atomic weights in relation to disease conditions we are considering the problem of the venereal taints, syphilis and sycosis. Just as we find the remedies preeminently antipsoric in the lower register of atomic weights -below 53- and just as we find these closely related to the constructive elements in living tissue, so we find the elements with the highest powers of destruction in the upper and highest registers of atomic weights.

     It is to be remembered that the constructive elements are, as Millikan states, “in their state of maximum stability already; they have no energy to give up in the disintegrating process. They can only be broken apart by working upon them, or by supplying energy to them…” However, when we consider the radioactive elements we find the problem an entirely different one, and necessarily their homœopathic field of action will be different. We cannot expect construction from essentially destructive forces, so long as they remain in their natural state.

     Millikan tells us that the process of radioactive disintegration is a process that can take place only in the case of a very few of the very heavy elements; that radioactivity is a heat-evolving (exothermic) process; that it is self-destructive in that it gives off of itself in the process and after this process has continued a sufficient length of time the original substance is itself changed; it has become more inert and has less and less radioactive properties and powers. We are told that Uranium, after it has discharged its alpha particles for a considerable period of time (geologically considered) has become so much lighter in atomic weight that we recognize it as Thorium; this eventually is worn down into Radium, and this in turn disintegrates into Lead. Thus we see that these radioactive elements have no choice; they cannot rest in their ceaseless self-destruction, and they cannot come in contact with other substances without in turn destroying them.

     We have stated that syphilis is the only miasm or stigma that actually destroys living tissue. It destroys not only soft tissues but bony tissues, and attacks the very life of the unborn child. If, after repeated abortions, a child is born to a parent having this marked taint, we frequently find the tissues so disturbed by the attack of the disease that it were better the child had died. If the child is not actually disfigured, and attains the age of puberty, we are sure to find this cruel stamp upon it. The symptoms of this miasm as they appear all down its trail have been stated in detail previously. Now we have to consider the chemical affinity of certain elements to the disease taint-in other words, the foreordained homœopathicity.

     If Sulphur is the remedy that most clearly typifies the psoric classification, so Mercury is the closest remedial synonym for the syphilitic. We find Mercury in the higher range of elements; in fact, from Osmium (76) onward we may consider the proven range of the antisyphilitics. Reference to the homœopathic materia medica will give us a clear outline of the symptomatology of Osmium, Iridium, Platinum, Aurum, Mercury, Plumbum, Bismuth, Radium and Uranium. We have not sufficient provings of some of the other elements in this range. But we often find some of the remedies indicated in these conditions that come in the lower, or constructive, register. How are we to account for this?

     McMillan, Thornton and Lawrence of the University of California reported before the National Academy of Sciences in 1935 that they had developed a process whereby certain of the lower elements had been made radioactive. This end was accomplished by “breaking through the enormously high energy barrier that surrounds the nucleus of the atom” and for this purpose they employed a special apparatus, perfected for the purpose, with a very low amperage and very high voltage. Copper and sodium chloride were both made artificially radioactive, and the sodium chloride remains radioactive in solution, even when injected into the tissues.

     They were quoted as stating further: “A single drop of water contains enough energy to supply 200 horse power continuously for a year, but at present it takes more energy to break into the atom than is released. When this ratio can be reversed atomic energy will be available.”

     Millikan says of the more common and lighter elements (such as sodium, for instance): “Man can probably learn to disintegrate them, but he will always do it ‘by the sweat of his brow’.”

     Here again we see that radioactivity and disintegration are a common thought, and this applies equally to the syphilitic stigma.

     We frequently find a patient susceptible to the action of Natrum mur. in potentiated form -that is, the form in which the energies have been released by applied force in the form of succussion- who has partaken repeatedly and frequently of salt in the diet with no appreciable vital effect. Yet in the continued attack by force and motion upon the construction of the sodium atom, these energies have been released so that the substance is changed in its very essentials, and it takes on and retains an artificial radioactivity which activates it for a considerable period of time. So it is with many other substances, seemingly inert in their natural state, which take on activity under the homœopathic potentiation.

CHAPTER XXVII
DISEASE CLASSIFICATION; THE SYPHILITIC STIGMA, CONTINUED

     It has been said that the patient afflicted with the syphilitic taint suffers from structural changes; yet the emotional sphere in the purely syphilitic patient is not seriously affected. For this reason, in the syphilitic patient we find less subjective symptoms; there is little of the supersensitiveness, and less desires, cravings and longings than in the psoric patient. The syphilitic patient actually suffers much less than the psoric; the mental sphere has not been so much invaded, for the syphilitic stigma is not so thoroughly established through untold centuries of time as the psoric, and because it is not so thoroughly a part of the very essence of man’s spirit we have a far better chance to eradicate the dyscrasia.

     The very earmarks of the various stigmata show their respective characters. The psoric itches, and appears unclean, unwashed. The syphilitic ulcerates and the bony structure is changed. The sycotic infiltrates and is corroded by its discharges.

     Psora is the stigma which shows little on the side of objective symptoms, but expresses itself through the mental and emotional reactions. For this reason the patient of a tubercular diathesis reflects many subjective symptoms in comparison with the purely syphilitic for, as has been pointed out before, the tubercular is the combination of the psoric and syphilitic. In this combination we find all the mental and emotional reactions, the subjective symptoms, of the predominant parent, psora, and the pathological and destructive changes of the younger parent, syphilis.

     Syphilis alone has few cravings in the way of food; it is averse to meats, but aside from that negative symptom there is little that we note in the way of appetite. Compare that state with the tubercular cravings, which were pointed out in the last chapter.

     The frequent, unsatisfied hunger; the craving for meat and potatoes when nothing else will satisfy; the craving for salt; craving for indigestible things; the inability to assimilate much starch; these marked symptoms of appetite show the psoric parent-age of the tubercular diathesis.

     In the syphilitic-psoric type we find the changes in the chest wall, which are structural changes in the bone contours. The chest wall is narrow and may be more shallow than normal; even the action of the diaphragm is limited. While there may be no structural changes in the lung itself, there is less air capacity and less residual air in the lung. The very structural changes eventually bring about occlusion of the air cells and the formation of foci, for these people are very poor breathers; the pumping power is so cramped that they are incapable of supplying sufficient oxygen for the body needs. This is shown in the anemic and chlorotic conditions, as well as in the tubercular. The tuberculosis produces its destruction by first cramping the aeration of the red blood cell through the formation of the bony structure. Because breathing is a difficult process they become averse to fresh air, and will survive for a long time in a close, breathed-over atmosphere.

     Long before tuberculosis develops, sometimes even years before, you may notice a symptom of the latent diathesis: on the least exposure to cold the patient develops a deep, hoarse cough. This will be repeated many, many times before there is actual development of the tuberculosis. The purely syphilitic patient has a short, barking cough; this is sometimes true of the early tubercular stages.

     The tubercular expectoration is purulent, greenish-yellow, often offensive; usually sweetish or salty to his taste. We can usually depend upon the salty or sweetish taste as being a characteristic of this dyscrasia.

     There is the everlastingly tired feeling of the tubercular type: (the psoric is always ready to lie down); the tubercular patient is better in the daytime and worse as night comes on, showing the syphilitic influence. The syphilitic patients should be sun-worshippers in type, for they are always better during the day-light hours, and all conditions are < at night. The tubercular people suffer from neuralgias, prosopalgias, sciaticas, insomnias, hysterias, and all the nervous symptoms peculiar to the diathesis. They may have for years persistent headaches; this may precede the actual tubercular development. Hysterical and other nervous symptoms often precede the tubercular manifestation, and when the lung condition improves the lung condition takes on renewed activity. Often a severe dysmenorrhœa will stay for a time the disease progress in the lung itself. In other words, the pre-tubercular manifestations are more psoric than syphilitic; but the structure predisposing to develop the lung condition is syphilitic.

     When children cry out in their sleep we may take this to be an indication of the tubercular diathesis, which may take on a meningeal form when it develops. Look carefully to all night aggravations, especially in children, to see if they are not pre-tubercular indications.

     The tubercular diathesis has many heart symptoms, showing the psoric parentage. There is much palpitation. In the psoric this is due to uterine or gastric irritations and disturbances; in the sycotic patients the heart manifestations are reflexes of rheumatic conditions. In the syphilitic and sycotic stigmata we find little mental disturbance accompanying the heard conditions, even when the conditions are critical; it is the psoric patient who worries about his heart condition are rarely succumbs to it. It is the syphilitic or sycotic patient who may have for years a slight dyspnœa and occasionally slight pains, or perhaps no symptoms at all, but they die suddenly and without warning.

     In the tubercular, as in the psoric heart conditions, the patients want to keep still; they are much < by higher altitudes; cannot climb stairs or ascend hills; cannot breathe well on ascending; have not the proper amount of room for air. They have no difficulty in descending. With this heart condition there is a cyanosis that is often painful. There is a gradual falling away in flesh in these conditions. The syphilitic dropsies and anasarcas are greater than the sycotic.

     Lymphatic involvement of the abdomen is of tubercular origin, as are the hernias; the muscles lack tone.

     Hereditary syphilitic troubles in children sometimes produce a very watery discharge that almost completely drains the system of its vital fluids and unless promptly corrected death ensues. The cholera infantum types of diarrhœa are syphilitic; we often find tubercular diarrhœas which simulate the cholera infantum, but they do not as rapidly drain the system. In the tubercular diarrhœas we find the < in the night or the early morning, driving the patient out of bed, and < by cold, showing the syphilitic relationship. The tubercular child often cannot assimilate cows’ milk in any form; the casein has to be modified before it can be digested at all. These are the children who have undigested curds in the loose stool.

     There is a close relationship between the ability to take the lime salts from food and these diarrhœas of tubercular children; this is the reason for the difficult and irregular dentition and the craving for the elements which the body needs; they cannot assimilate the necessary elements from their food. The diarrhœas of the syphilitic child who is strongly tainted with sycosis will probably call for some such remedy as Croton tig. or Sarsaparilla.

     The tubercular stool is apt to be slimy, bloody, with a musty, mouldy smell; nausea and gagging before stools and prostration with a desire to be left alone after stools. Hemorrhages from the rectum are signposts of tuberculosis, although there are bleeding hemorrhoids in sycosis. Tubercular patients are troubled with pin worms and seat worms. The characteristic alternation of symptoms in the tubercular patient may be noted in the alternation of rectal diseases with heart, chest or lung troubles, especially in asthma or respiratory difficulties. Very often, operated or suppressed hemorrhoids will be followed by asthmatic manifestations, often accompanied by heart troubles.

     In the rectum, strictures, sinuses, fistulas and pockets are all of tubercular origin, but these conditions are much more frequent and in much aggravated form when combined with the sycotic stigma. Cancerous manifestations of the rectum are a combination of the tubercular and sycotic; in other words, they are a manifestation of the combined destructive force of the three stigmata. Psora alone never reaches to pathological changes; yet without the psoric element malignancies will never develop.

     In the urinary tract all of the stigmata may manifest them-selves, but most frequently these manifestations are psoric and sycotic; here also the combined assault of all three stigmata are represented in the malignancies. The diabetic patient is as a rule strongly tubercular; sometimes in these conditions there is a strong taint of the sycotic, which makes the condition much more malignant. We never see market tissue changes or fibrous growths without the presence of the three stigmata, although the tubercular and sycotic are represented in the majority of cases of Bright’s disease. While the psoric element is present in these conditions, it is not in as marked degree as the syphilitic and sycotic.

     Nocturnal enuresis, with the < during sleep and soon after falling asleep, are tubercular; and nightly emissions also are a combination of the syphilitic and psoric taints. Usually prostatic troubles may be classed under the union of these two stigmata.

     Syphilis seldom attacks the ovaries or the uterus. In pathological conditions we occasionally find a manifestation of the tubercular diathesis, but this is because of the psoric affinity for functional and emotional disturbances and not because of the syphilitic influence toward these organs.

     The syphilitic stigma attacks the long bones; the growing pains of children are syphilitic, especially when < at night, < in storms or on change of weather. This stigma causes destruction of tissue partly because it hampers assimilation of the necessary elements, and we see the result in rickets of children; they cannot assimilate from their food what they require to make the bones sufficiently hard to support their weight without bending.

     The nails of these patients are characteristic, being paper-thin, spoon-shaped and bending and tearing easily. Where the nails are irregular, brittle, break and split easily, and with many hangnails, this is an unfailing sign of the tubercular; these nails are also spotted, or with white specks, and scalloped edges. Felons about the nail are a manifestation of the combined effects of syphilis and psora, as are all periosteal affections.

     The psoric-syphilitic patients cannot endure much cold, yet they cannot endure much heat; the heat from the stove may drive them from the room.

     Chilblains are a combination of all the stigmata. Anyone who has endured the torments of this affection can readily understand how willing these sufferers are to accept any form of treatment which promises some relief; yet a suppression of this manifestation brings in its train a succession of all sorts of nervous diseases and many other serious conditions, even to malignancies.

     Corns and like hypertrophies are tubercular manifestations. Boils are usually psoric, but when there is much suppuration and pain it is usually a combination of the psoric and syphilitic manifestations. It is characteristic of psoric eruptions that they tend to dry down and scale off rather than to suppurate. However, the appearance of boils after the administration of the antipsoric remedy is a welcome and encouraging indication.

     Children who have weak wrist and ankle joints, who have difficulty in holding on to objects, who drop things easily, who are clumsy in getting about and stumble over a straw, are manifesting the effects of the combined syphilis and psora, for this combination affects the tendons about the joints by weakening them so that they will not stand the strain of much use.

     As we naturally expect, there are a great many skin manifestations with the syphilitic miasm and in the tubercular dyscrasia. There are pustular eruptions which suppurate, and eruptions occur especially about the joints or in the flexures of the body. These eruptions are quite prone to arrange themselves in crescentic formation. In color they are coppery or brownish, but sometimes very red at the base of the pustules. The most striking characteristic of these syphilitic eruptions is that they do not itch, and there is very little soreness. If these eruptions progress to scaling and crusts, as they usually do, these are very thick and occur in patches or circumscribed spots.

     The gangrenes of the skin and dry gangrenes show the destructiveness of the syphilitic stigma.

     Skin affections with glandular involvement are frequent. Occasionally psoriasis shows itself. Psoriasis has been called the marriage of all the miasms, or stigmata, but its characteristic are predominantly psoric and sycotic. Another type of eruption where all the stigmata are present is the fish scale eruption. In this condition we have the dryness of psora, the squamous character of the syphilitic eruption and the moles and warts of sycosis.

     Varicose veins are of tubercular origin. Varicose ulcers are the last destructive manifestation on the skin of the syphilitic taint. In this stigma, too, we see the ecchymoses and hæmorrhagic conditions into the skin; puerperal conditions are all manifestations of the syphilitic taint.

     Erysipelatous and carcinomatous conditions, epithelioma and lupus, are all manifestations of the union of the three stigmata. In acute exanthematous diseases we see the tubercular diathesis. These conditions show the psora in the severity of the attack, but the profound prostration from the lowered vitality is the mark of the syphilitic taint. Urticarias occur in the tubercular diathesis. Marked freckling is also a manifestation of the tubercular diathesis; this has the clear, almost transparent skin of the tubercular patient, with the pigmentation of the psoric. Impetigo will readily develop in the combination of the psoric and syphilitic stigmata, while those without this dyscrasia will not become infected.

     We often find patients with slight wounds that heal very slowly or not at all; this condition is due to the union of the syphilitic and psoric influences. In this same category we may place the stitch abscesses which occur following operative measures, in hospitals and under the best of sanitary conditions.

     We have spoken a great deal of the tubercular diathesis as being a combination of the syphilitic and psoric stigmata. The scrofulous diathesis is also a combination of these two stigmata, but it differs in the proportionate degree of the presence of the taints, and is further influenced by the suppressive measures of crude drugging. Probably environment and circumstances have some bearing on it also. However, the suppression is a strong factor in its individual expression, because this has buried it deeper in the system.

     The scrofulous diathesis manifests itself largely by the involvement of the glandular system, particularly the lymphatics. While many authorities have classed scrofula as psoric, its relation may be traced by its manifestations. Psora has no glandular involvement, but syphilis has a particular affinity for glandular tissue. Scrofula has many symptoms in common with psora, but it has the same tendency to ulceration as syphilis; this relationship may be seen also in the purulent discharges and decomposition of the exudations. Scrofula has the same tendency a syphilis to locate in the organs of the special senses, such as the eyes, ears, nose, lips, etc. The pernicious anemia of the scrofulous patient resembles very closely the syphilitic parent, and shows its kinship to the tubercular diathesis.