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.

Alumina 13. Ammonium mur. 1, 7, 17. Antimony 51. Argentum 47. Arsenic 33. Aurum mur. 17, 79. Baryta mur. 17, 56. Borax 1, 5, 8, 11. Bismuth 33. Bromium 35. Calcarea phos. 15, 20. Cinnabaris 16, 80. Chlorine 17. Ferrum iod. 26, 53. Ferrum phos. 15, 26. Fluoric acid 1, 9. Graphites 6, 14, 26.

Hepar sulph. 16, 20. Kali bich. 19, 24. Kali iod. 19, 53. Kali mur. 17, 19. Kali sulph. 16, 19. Lithium 3. Mercury 80. Merc. cor. 17, 80. Merc. i. r. 53, 80. Merc. sol. 1, 7, 8, 80. Natrum mur. 11, 17. Natrum sulph. 11, 16. Nitric acid. I, 7, 8. Phosphorus 15. Plumbum 82. Silica 14. Sulphur 16.

     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.