We will notice sometimes that symptoms take the wrong direction. For instance, if you prescribe for a rheumatism of the knees or feet, or for a rheumatism of the hands, and relief takes place at once in the rheumatism of the extremities, but the patient is taken down with violent internal distress that settles in the region of the heart, or centres in the spine, you see at once a transference has taken place from circumference to centre, and the remedy must be antidoted at once, otherwise structural change will take place in that new site.
When diseases go from centre to circumference, going out from the centres of life, out from the heart, lungs, brain and spine, out from the interiors, upon the extremities, it is well. So it is that we find most gouty patients get along best when their fingers and toes are in the worst condition.
To prescribe for this, and see the heart symptoms grow worse is a most uncomfortable state of affairs, for it is attended with a gradual downward tendency. Eruptions upon the skin and affections in the extremities are good signs. I remember one time I was discharged from a violent old woman with quite a considerable amount of Billingsgate, who told me that when she called me in she could walk about, and now her ankles were swelled up with rheumatism so that she could not move. That patient got another doctor, but soon died.
There is a great danger in selecting a remedy on external symptoms alone, i.e., selecting a remedy that corresponds only to the skin and ignoring all the symptoms that the patient may have, ignoring the whole economy and general state of the patient; because it is true that that remedy that is related to the skin alone may drive in that skin disease and cause it to appear while the patient himself is not cured. Such a patient will remain sick until that eruption comes back again, or locates in another place.