78. True chronic sickness remains uncured even after the strictest hygiene is established.
79. Syphilis and sycosis are chronic miasmatic diseases inextinguishable by the unaided vital force. They are internal maladies which entail perpetual evils, unless cured by the homoeopathic art.
80. Psora, hydra headed, is directly responsible for a host of so-called diseases which afflict the race. For an extended discussion of the chronic diseases psora, syphilis, sycosis see Hahnemann’s book Chronic Diseases.
81. Here is presented a long list of presumably distinct diseases which have developed, through countless generations, and many million human organisms, with every variety of constitution and circumstance of living through the effect of the psora miasm. The race has been unable to escape from the chronic miasm, psora, by reason of the persistent and indiscriminate suppression of every manner of skin eruption, by the habitual use of ointments and astringent washes, by doctors and granny women, through countless generations.
82. Psora must not be prescribed for without rigidly individualizing each particular individual case of chronic sickness.
83 Each case demands individualization and faithful recording with unbiased judgement and sound sense. That’s the rub!!! That’s the rub!!! Where shall we find the sound sense? 84 to 104. Taking the case.
84. The patient and attendant narrates history of sickness and describes sensations, symptoms and behaviour, the physician observes with sight, hearing, touch and smell and allows story to be finished; only not allowing digressions.
85. Write down each statement in a separate sentence one below the other.
86. After the statement is voluntarily ended, review it, get each statement definitely restated. Get the exact location of each pain, the character of the pain, whether lasting or interrupted or shifting, time of each pain, position of aggravation or amelioration or how it responds to heat, cold, air, rest, motion, posture, contact, touch or pressure. Get a complete description of each attack.
87. Don’t ask direct question, or question that can be answered by yes or no.
88. Don’t ask leading question or questions that suggest an answer.
89. At the close of the sceance, specific questions may be asked, to get exact information concerning character of stool, character of pain, nature of complaint or noises made by the patient, how he sleeps, how he breathes, whether snoring is on inspiration or expiration, etc., etc.
90. After these notes are completed the physician may then proceed to examine the physical state of the patient by any and every accessible method of physical examination to determine the amount of pathology developed, the state of physical function, the character of excretions and secretions, after which inquiry can be made into the peculiarities of the patient in time of health.
91. Inquiry must be made as to medicine taken, symptoms and sensations before, during and after taking the drug. Be careful not to include drug symptoms in totality of sick symptoms. The homoeopathic physician may become so familiar with the symptomatology of drugs that the drug symptoms may be recognized. Give placebo till drug symptoms have subsided. Drug symptoms when clearly exhibited may be antidoted by the appropriate remedy.
92. Sickness complicated with drug symptoms is much more difficult to prescribe for and cure than sickness unmodified by drug potencies.
93. Discover if sickness is due to some exciting cause, poison, self injury, masturbation, sexual excesses, excess in eating or wine, infection, venereal disease, domestic discord, marital infelicity, grief, hernia, bony malformation of nose, chronic appendicitis, malformation of throat, unerupted tonsils or wisdom teeth, foci of infection in teeth, tonsils, nose or sigmoid flexure, money losses, insult, fear, want, celibacy, anaphylaxis of the unrequited emotions of maidenhood, malformed sex organs, prolapsus of abdominal or pelvic organs, etc. Look for removable causes.
94. When investigating chronic sickness, habits of life, domestic relations, errors of living and hygiene must be looked into to discover if removable causes are responsible for sickness. If so these causes must be removed.
95. Chronic cases cannot be too carefully taken. Trivial and obscure symptoms must not be overlooked. Each symptom, objective and subjective, helps to complete the totality, and provide a basis for making a homoeopathic prescription.
96. Don’t be misled by exaggerated statements of sensitive, intolerant patient. 97. Don’t allow bashfulness, modesty, timidity, and obscure terms to render the case report partial or incomplete. 98. Don’t allow anxious or frivolous friends to make erroneous statements.
99. Acute cases are more quickly comprehended than chronic, since acute symptoms are more recent and more violent and impress the patient more vividly.
100. The taking of the case involves more than just naming it according to its most prominent symptom. The doctor who pretends to know all about a case without previously having investigated that particular case is a fraud, and his pretense is only an exhibition of assinine egotism. The need of examining individual sick cases applies also to the individual cases of epidemics, such as grip, flu, measles, scarlet fever, diphtheria, smallpox, mumps, typhoid fever, colds, coughs, etc.
101. A single case will not present the totality of symptoms of an epidemic sickness. Well intentioned modest physicians will co-operatively study an epidemic sickness to discover its most certain curative remedy, and apply it for the benefit of humanity and the credit of scientific medicine.
102. The distinguishing characteristic of any epidemic sickness will be secured in the composite image of the totality of symptoms of several patients of different bodily constitution. This composite picture of the epidemic sickness will reveal the remedy for that epidemic. That remedy will master the epidemic, reduce the death rate, rob epidemics of their horror, and dedicate physicians to the mission of genuine public service.
103. The image of the chronic miasm, psora, can be construed out of the composite image of the totality of symptoms of a great many chronic cases. By this labor only can physicians gain a comprehensive knowledge of the character of the chronic miasm that is afflicting the human race, and become able to master and eradicate it from human experience.
104. The image construed by the taking of the case as above detailed, is the basis for the selection of the remedy which has a strikingly similar pathogenesis. The remedy so selected is the similimum. The labor of making this selection constitutes the important item in the technique of homoeopathic prescribing. The well arranged repertory and the well stated materia medica facilitates the selection and lightens the labor. A preparation for this labor involves the task of making acquaintance of a good repertory and mastering as far as is possible the peculiar genius of the best proved drugs. This latter achievement is no slight task and can be contemplated with equinimity only by feeling that the effort will be recompensed by a service to the sick, unequalled in curative merits by any other therapeutic modality known to the science of internal medicine. When the patient has received the similimum and all obstacles in the way of recovery have been removed the most has been done that can be done to insure a speedy, gentle, permanent cure.
105 to 145. Detail the method of proving remedies.
105. The second duty of the physician is the investigation of drugs.
106. The entire range of disease producing power of each drug should be know.
107. Drugs must be tested as to their power of altering health.
108. The acquisition of this knowledge cannot be left to chance.
109. Hahnemann claims to be the original drug prover. He claims originality in no other particular.
110. The results of provings, deliberately made, are frequently confirmed by poisonings accidentally or purposely inflicted.
111. Drug effects are unalterably fixed and eternal. Drugs act in obedience to fixed and eternal laws. Like cause produce like effects.
112. The primary drug effect is the direct drug action on the organism. The secondary drug action is the vital reaction excited by the primary drug effect. The difficulty of discriminating between these two actions has led to much controversy.
113. Narcotic drugs, almost invariably, produce two conspicuous effects, primary and secondary.
114. The proving of drugs is not hurtful to provers if the vital force is not overwhelmed by too massive doses or too frequent repetition of the dose.
115. Some drugs produce alternating symptoms.
116. Some drug symptoms appear with tolerably uniform regularity in each of the several provers, other symptoms appear rarely and with only isolated provers.
117. This latter class may possess, so-called, idiosyncrasies, however, this peculiarity is more apparent than real, since drugs, when indicated by similarity of symptoms never fail to produce curative reactions. However there are certain constitutions that seem to be morbidly affected by certain things that produce no impressions on others. It is a question whether the susceptibility or the immunity is peculiar.
