Another general remark needs to be made, namely, that we should know by the symptoms if the changes occurring are sufficiently interior. If the changes that are occurring are exterior, the physician must be acquainted with the meaning of them, so that he will know by that whether the disease is being healed from the innermost or whether the symptoms have merely changed according to their superficial nature.
Incurable diseases will very often be palliated by mild medicines that act only superficially, act upon the sensorium, act upon the senses, and, though the hidden and deep-seated trouble goes on and progresses, and is sometimes made worse, yet the patient is made comfortable. So that by the symptoms we can know whether the changes that are occurring are of sufficient depth, so that the patient may recover. The direction that the symptoms are taking is sufficient to tell that, especially in chronic disease.
A patient walks into the clinic, somewhat stoop-shouldered, with a hacking cough that he has had for a good many years. You judge by his looks that he has been sick a good while; his face is sickly, he is lean and anxious, he is careworn, he is suffering from poverty and poor clothing and scanty food. Now, you examine all his symptoms, and they clearly indicate that he needs an antipsoric, for the symptoms are covered by an antipsoric, and from the history of the case you know he has needed it a good while.
Upon prolonged examination, the antipsoric you have in mind is strengthened. You now examine his chest, and discover he has not the expansion that he ought to have, and you detect the presence of tuberculosis, and by feeble pulse and many other corroborating symptoms you ascertain that the patient has been steadily declining.