The motion advanced by Dr. Puffer and others that the general disease is relieved or silenced by a skin eruption is in many cases not true, for patients die of typhus or of inflammation though a skin disease may appear in the course of the disease, and some febrile diseases, such as small-pox, measles, scarlatina, etc., are severe in the direct proportion of the extent of skin-disease they present. That impetiginous diseases disappear on the occurrence of typhus is not a sign that the intensity of the typhus has anything to do with such disappearance, for it is rather in consequence of the general disease that the skin-disease disappears. In syphilis the occurrence of the syphilitic skin-disease does not suppress the other effects of this malady, for such syphilitic exanthemata often co-exist with iritis, sore throat ozaena, and nodes.
Notwithstanding all this and many other assertions and facts, Dr. Hebra is far from denying the reciprocal relation of the skin and other parts of the organism. He again repeats his assertion that the general eruption on the skin of scabious patients is caused by their own scratching, and refers to cases of itchy persons paralysed in the upper extremities who presented no general eruption, but only the scabious vesicles and canaliculi on the parts inhabited by the acarus. Hebra asserts that it is always his endeavour in all cases of skin diseases and ulcers to heal them as quickly as possible by external remedies, and he invites all those who dream of the bad effects of such treatment to watch his practice as carefully as they like. He laughs at the motion of a secondary disease from a suppressed cutaneous eruption requiring an incubation period of several years.
Dr. Griesselich, in the work to which I have frequently referred in these lectures, pays great attention to Hahnemann’s psora- theory, and enters at length into all the different points of a practical and theoretical nature involved in it.
The truths contained in Hahnemann’s psora-theory, he says, go to supply many wants in the Hahnemannic homoeopathy, as it had previously existed. When Hahnemann talks of the utter inefficacy of the treatment of chronic diseases he is guilty of great exaggeration, a fault which he very frequently commits; for there is no doubt that chronic diseases were cured by Hahnemann himself, as we learn from many cases detailed in his Lesser Writings, before the discovery of the psoric origin of diseases, and before he know a single so-called anti-psoric medicine. Griesselich regards the psora-doctrine as supplying a defect in the otherwise hyperdynamic doctrines of Hahnemann, and an acknowledgment that what is called the complex or totality of the symptoms is not the sole indication for the choice of the drug. By the psora-theory the material organism and the relation of the disease to its exciting cause are restored to a portion of their rights, and the choice of the remedy is made to depend, not only on the morbid symptoms actually present, but also on those that have been and are the cause of the disease.
Thus diseases are tacitly acknowledge to be something more than dynamic disturbances of the sensations, as Hahnemann elsewhere describes them. As Hahnemann further asserts that an individual will only be affected with acute disease provided he be of psoric habit, this doctrine of chronic diseases has also an effect upon that of acute diseases. However, Hahnemann’s dynamism is observable even in this his psor-theory, which is otherwise of such a material and humoral pathological character; for he states, as you may remember I observed in my last lecture, that the nerve receives impression of the miasm and communicates it to the other nerves, an opinion which, Griesselich remarks, needs no refutation now-a- days, for the nerve only receives or conducts, those things that it is adapted for. From Hahnemann’s psora-theory it would appear that chronic diseases are only derived from an actual infection with itch, symptoms, or sycosis, itch being the provoking cause of seven-eighths of these chronic diseases.
Actual infection with one or several of these three diseases is the sole source of all true chronic diseases according to him, and these unassisted nature can never overcome; but still he admits the occurrence of another sort of chronic diseases, which he says are improperly so termed, and which are improperly so termed, and which are produced by exposure to avoidable noxious agencies, such as intemperances, dissipation, unhealthy situations, want of exertions, etc., but these will, he says, disappear of themselves when their exciting causes are removed. Griesselich declares Hebra’s views of the complete localization of skin diseases to the not only erroneous but dangerous. He says that the experience of every practitioner will furnish him with cases where, after the suppression of a skin disease, a neuralgia, a paralysis, or other serious disease, worse than the primary one, occurred, evidently connected with the suppressed skin diseases.
He says it is indifferent whether we employ the term psora or the more usual ones of dyscrasia, cachexia, or acrid humours to designate the general disease. We cannot fail to perceive in a vast number of skin diseases the reflection, as it were, of the general morbid condition of the organism, and at the same time a means of keeping that general disease in a slumbering or latent state; but he is also of opinion that the skin may be subject to merely local diseases, which may safely be treated with local means. In the narrower sense of the term, he says the psora-theory, viewed as a mere theory of the origin of most chronic diseases from itch, is miserably one-sided, for the previous existence of itch is by no means always capable of being proved, and the occurrence of itching of the skin or eruptions thereon in the treatment of chronic diseases cannot be regarded as a proof of the previous existence of itch. But in the wider sense of the term, as indicating cachexia or dyscrasia, the psora-theory is, he asserts, founded in nature and truth.
With regard to the itch itself, Griesselich says that there is no other characteristic sign of itch but the presence of the acarus and its peculiar canaliculi. He rejects the idea of a spontaneous generation of the acarus from the itch-virus, and asserts that they must always come from without, and are propagated, like other insects, from eggs. Both Hahnemann, it was the universal belief in his day. Griesselich thinks that all the evidence is against the inoculation of itch by means of the fluid from the vesicles and in favour of it by means of the acarus, the recorded experiments apparently of a contrary character he succeeds in explaining satisfactorily.
Hebra’s doctrine of the eruption over the whole body being caused by the sympathetic irritation and consequent scratching, he gives implicit credit to, and cites from his own experience several analogous facts, such as the general irritation produced by the application of rhus-leaves to one part, and that caused by the bites of certain insects. If we regard the acarus as the essential agent in the itch-as the itch itself-there can, he says, be no question of a retrocession of the itch-matter, as no such matter exists. There can be no itch-metastasis, as the acarus can only live on the skin. We can only rightly speak of secondary itch diseases provided the sarcoptes itch was previously on the skin. It is, says he, a question whether patients who have been cured of itch homoeopathically, by internal remedies only, remain free from after-diseases. Kampfer (Allg. h. Ztg., Bd. 26, p, 34.) doubts it. There are two points, the consideration of which must give us quite a different idea of the after-diseases of itch.
1. The constitution of the individual affected by itch.
2. The medicinal means that have been employed for its cure.
Griesselich supposes a case in illustration of the influence of these two circumstances. A tall thin man, whose father died of phthisis, suffers frequently from epistaxis, has occasionally had haemoptysis, he looks ill and declining, though he has not presented the signs of fully developed phthisis. He becomes infected with itch, the whole skin is covered with eruption, the poor patient cannot sleep, he loses his appetite, becomes thinner and thinner, rubs in first one ointment, then another, takes purgatives, drinks herb-teas to purify his blood, and gradually gets worse and worse. Some old woman advises him to use a salve containing turpentine, the eruption disappears, but the whole organism, which was already in a declining state before the itch came on, is so seriously involved by the whole course of the cutaneous diseases and its treatment, that fully developed phthisis now breaks out; the latent or subacute state might have continued for a long time unnoticed, but the smouldering fire now burst forth and complete phthisis is the result. Of course the harm resulting from such treatment would be much greater if medicinal poisons like lead or mercury had been plentifully used. In brief, says Griesselich, these so-called secondary itch- diseases cannot, in most cases, be regarded as consequences of ill-treated or spontaneously cured itch, but as maladies the germ of which lay in the organism before the itch was contracted, and which burst forth during the course of the cutaneous diseases. A medicinal disease, such as that caused by the abuse of mercury, often plays a part in the affair. Itch and its bad treatment appear to be the awakeners of slumbering tendencies to disease, just as ancient germs burst forth also after measles, scarlatina typhus, etc.
Robert Ellis Dudgeon practiced at the London Homeopathic Hospital and specialised in Optics.
Robert Ellis Dudgeon wrote Pathogenetic Cyclopaedia 1839, Cure of Pannus by Innoculation, London and Edinburgh Journal of Medical Science 1844, Hahnemann’s Organon, 1849, Lectures on the Theory & Practice of Homeopathy, 1853, Homeopathic Treatment and Prevention of Asiatic Cholera 1847, Hahnemann’s Therapeutic Hints 1847, On Subaqueous Vision, Philosophical Magazine, 1871, The Influence of Homeopathy on General Medical Practice Since the Death of Hahnemann 1874, Repertory of the Homeopathic Materia Medica, 2 vols 1878-81, The Human Eye Its Optical Construction, 1878, Hahnemann’s Materia Medica Pura, 1880, The Sphygmograph, 1882, Materia Medica: Physiological and Applied 1884, Hahnemann the Founder of Scientific Therapeutics 1882, Hahnemann’s Organon 1893 5th Edition, Prolongation of Life 1900, Hahnemann’s Lesser Writing.