Aphorism 191 to 200


In the treatment of skin diseases local application of medicines must be avoided as it leads to suppression of the disease. A homeopathic similar remedy must be given for all external local diseases….


§ 191

This is confirmed in the most unambiguous manner by experience, which shows in all cases that every powerful internal medicine immediately after its ingestion causes important changes in the general health of such a patient, and particularly in the affected external parts (which the ordinary medical school regards as quite isolated), even in a so-called local disease of the most external parts of the body, and the change it produces is most salutary, being the restoration to health of the entire body, along with the disappearance of the external affection (without the aid of any external remedy), provided the internal remedy directed towards the whole state was suitable chosen in a homoeopathic sense.

§ 192

This is best effected when, in the investigation of the case of disease, along with the exact character of the local affection, all the changes, sufferings and symptoms observable in the patient’s health, and which may have been previously noticed when no medicines had been used, are taken in conjunction to form a complete picture of the disease before searching among the medicines, whose peculiar pathogenetic effects are known, for a remedy corresponding to the totality of the symptoms, so that the selection may be truly homoeopathic.

§ 193

By means of this medicine, employed only internally (and, if the disease be but of recent origin, often by the very first dose of it), the general morbid state of the body is removed along with the local affection, and the latter is cured at the same time as the former, proving that the local affection depended solely on a disease of the rest of the body, and should only be regarded as an inseparable part of the whole, as one of the most considerable and striking symptoms of the whole disease.

§ 194

It is not useful, either in acute local diseases of recent origin or in local affections that have already existed a long time, to rub in or apply externally to the spot an external remedy, even though it be the specific and, when used internally, salutary by reason of its homoeopathicity, even although it should be at the same time administered internally; for the acute topical affections (e.g., inflammations of the individual parts, erysipelas, etc.), which have not been caused by external injury of proportionate violence, but by dynamic or internal causes, yield most surely to internal remedies homoeopathically adapted to the perceptible state of the health present in the exterior and interior, selected from the general store of proved medicines,1 and generally without any other aid; but if these diseases do not yield to them completely, and if there still remain in the affected spot and in the whole state, notwithstanding good regimen, a relic of disease which the vital force is not competent to restore to the normal state, then the acute disease was (as not infrequently happens) a product of psora which had hitherto remained latent in the interior, but has now burst forth and is on the point of developing into a palpable chronic disease.

1 Foot-note in Fifth Edition only.

As, for instance, aconite, rhus, belladonna, mercury, etc.

§ 195

In order to effect a radical cure in such cases, which are by no means rare, after the acute state has pretty well subsided, an appropriate antipsoric treatment (as is taught in my work on Chronic Diseases) must then be directed against the symptoms that still remain and the morbid state of health to which the patient was previously subject. In chronic local maladies that are not obviously venereal, the antipsoric internal treatment is, moreover, alone requisite.

§ 196

It might, indeed, seen as though the cure of such diseases would be hastened by employing the medicinal substance which is known to be truly homoeopathic to the totality of the symptoms, not only internally, but also externally, because the action of a medicine applied to the seat of the local affection might effect a more rapid change in it.

§ 197 Fifth Edition

This treatment, however, is quite inadmissible, not only for the local symptoms arising from the miasm of psora, but also and especially for those originating in the miasm of syphilis or sycosis, for the simultaneous local application, along with the internal employment, of the remedy in diseases whose chief symptom is a constant local affection, has this great disadvantage, that, by such a topical application, this chief symptom (local affection)1 will usually be annihilated sooner than the internal disease, and we shall now be deceived by the semblance of a perfect cure; or at least it will be difficult, and in some cases impossible, to determine, from the premature disappearance of the local symptom, if the general disease is destroyed by the simultaneous employment of the internal medicine.

1 Recent itch eruption, chancre, condylomata.

§ 197 Sixth Edition

This treatment, however, is quite inadmissible, not only for the local symptoms arising from the miasm of psora, but also and especially for those originating in the miasm of syphilis or sycosis, for the simultaneous local application, along with the internal employment, of the remedy in diseases whose chief symptom is a constant local affection, has this great disadvantage, that, by such a topical application, this chief symptom (local affection)1 will usually be annihilated sooner than the internal disease, and we shall now be deceived by the semblance of a perfect cure; or at least it will be difficult, and in some cases impossible, to determine, from the premature disappearance of the local symptom, if the general disease is destroyed by the simultaneous employment of the internal medicine.

1 Recent itch eruption, chancre, condylomata, as I have indicated in my book of Chronic Diseases.

§ 198

The mere topical employment of medicines, that are powerful for cure when given internally, to the local symptoms of chronic miasmatic diseases is for the same reason quite inadmissible; for if the local affection of the chronic disease be only removed locally and in a one-sided manner, the internal treatment indispensable for the complete restoration of the health remains in dubious obscurity; the chief symptom (the local affection) is gone, and there remain only the other, less distinguishable symptoms, which are less constant and less persistent than the local affection, and frequently not sufficiently peculiar and too slightly characteristic to display after that, a picture of the disease in clear and peculiar outlines.

§ 199

If the remedy perfectly homoeopathic to the disease had not yet been discovered1 at the time when the local symptoms were destroyed by a corrosive or desiccative external remedy or by the knife, then the case becomes much more difficult on account of the too indefinite (uncharacteristic) and inconstant appearance of the remaining symptoms; for what might have contributed most to determine the selection of the most suitable remedy, and its internal employment until the disease should have been completely annihilated, namely, the external principal symptom, has been removed from our observation.

1 As was the case before my time with the remedies for the condylomatous disease (and the antipsoric medicines).

§ 200 Fifth Edition

Had it still been present to guide the internal treatment, the homoeopathic remedy for the whole disease might have been discovered, and had that been found, the persistence of the local affection during its internal employment would have shown that the cure was not yet completed; but were it cured on its seat, this would be a convincing proof that the disease was completely eradicated, and the desired recovery from the entire disease was fully accomplished – an inestimable, indispensable advantage.

§ 200 Sixth Edition

Had it still been present to guide the internal treatment, the homoeopathic remedy for the whole disease might have been discovered, and had that been found, the persistence of the local affection during its internal employment would have shown that the cure was not yet completed; but were it cured on its seat, this would be a convincing proof that the disease was completely eradicated, and the desired recovery from the entire disease was fully accomplished – an inestimable, indispensable advantage to reach a perfect cure.

Samuel Hahnemann
Samuel Hahnemann