In the rectum, strictures, sinuses, fistulas and pockets are all of tubercular origin, but these conditions are much more frequent and in much aggravated form when combined with the sycotic stigma. Cancerous manifestations of the rectum are a combination of the tubercular and sycotic; in other words, they are a manifestation of the combined destructive force of the three stigmata. Psora alone never reaches to pathological changes; yet without the psoric element malignancies will never develop.
In the urinary tract all of the stigmata may manifest themselves, but most frequently these manifestations are psoric and sycotic; here also the combined assault of all three stigmata are represented in the malignancies. The diabetic patient is as a rule strongly tubercular; sometimes in these conditions there is a strong taint of the sycotic, which makes the condition much more malignant. We never see marked tissue changes or fibrous growths without the presence of the three stigmata, although the tubercular and sycotic are represented in the majority of cases of Bright’s disease. While the psoric element is present in these conditions, it is not in as marked degree as the syphilitic and sycotic.
Nocturnal enuresis, with the worse during sleep and soon after falling asleep, are tubercular; and nightly emissions also are a combination of the syphilitic and psoric taints. Usually prostatic troubles may be classed under the union of these two stigmata.
Syphilis seldom attacks the ovaries or the uterus. In pathological conditions we occasionally find a manifestation of the tubercular diathesis, but this is because of the psoric affinity for functional and emotional disturbances and not because the syphilitic influence toward these organs.
The syphilitic stigma attacks the long bones; the growing pains of children are syphilitic, especially when worse at night, worse in storms or on change of weather. This stigma causes destruction of tissue partly because it hampers assimilation of the necessary elements, and we see the result in rickets of children; they cannot assimilate from their food what they require to make the bones sufficiently hard to support their weight without bending.
The nails of these patients are characteristic, being paper- thin, spoon-shaped and bending and tearing easily. Where the nails are irregular, brittle, break and split easily, and with many hangnails, this is an unfailing sign of the tubercular; these nails are also spotted, or with white specks, and scalloped edges. Felons about the nail are a manifestation of the combined effects of syphilis and psora, as are all periosteal affections.
The psoric-syphilitic patients cannot endure much cold, yet they cannot endure much heat; the heat from the stove may drive them from the room.
Chilblains are a combination of all the stigmata. Anyone who has endured the torments of this affliction can readily understand how willing these sufferers are to accept any from of treatment which promises some relief; yet a suppression of this manifestation brings in its train a succession of all sorts of nervous diseases and many other serious conditions, even to malignancies.
Corns and like hypertrophies are tubercular manifestations. Boils are usually psoric, but when there is much suppuration and pain it is usually a combination of the psoric and syphilitic manifestations. It is characteristic or psoric eruptions that they tend to dry down and scale off rather than to suppurate. However, the appearance of boils after the administration of the antipsoric remedy is a welcome and encouraging indication.
Children who have weak wrist and ankle joints, who have difficulty in holding on objects, who drop things easily, who are clumsy in getting about and stumble over a straw, are manifesting the effects of the combined syphilis and psora, for this combination affects the tendons about the joints by weakening them so that they will not stand the strain of much use.
As we naturally expect, there are a great many skin manifestations with the syphilitic miasms and in the tubercular dyscrasia. There are pustular eruptions which suppurate, and eruptions occur especially about the joints or in the flexures of the body. These eruptions are quite prone to arrange themselves in crescentic formation. In colour they are coppery or brownish, but sometime very red at the base of the pustules. The most striking characteristic of these syphilitic eruptions is that they do not itch, and there is very little soreness. If these eruptions progress to scaling and crusts, as they usually do, these are very thick and occur in patches or circumstances spots.
The gangrenes of the skin and dry gangrenes show the destructiveness of the syphilitic stigma.
Skin affections with glandular involvement are frequent.
Occasionally psoriasis shows itself. Psoriasis has been called the marriage of all the miasms, or stigmata, but its characteristics are predominantly psoric and sycotic. Another type of eruption where all the stigmata are present is the fishscale eruption. In this condition we have the dryness of psora, the squamous character of the syphilitic eruption and the moles and warts of sycosis.
Varicose veins are of tubercular origin. Varicose ulcers are the last destructive manifestation on the skin of the syphilitic taint. In this stigma, too, we see the ecchymoses and haemorrhagic conditions into the skin; purpureal conditions are all manifestations of the syphilitic taint.
Erysipelatous and carcinomatous conditions, epithelioma and lupus, are all manifestations of the union of the three stigmata. In acute exanthematous diseases we see the tubercular diathesis. These conditions show the psora in the severity of the attack, but the profound prostration from the lowered vitality is the mark of the syphilitic taint. Urticarias occur in the tubercular diathesis. Marked freckling is also a manifestation of the tubercular diathesis; this has the clear, almost transparent skin of the tubercular patient, with the pigmentation of the psoric. Impetigo will readily develop in the combination of the psoric and syphilitic stigmata, while those without this dyscrasia will not become infected.
We often find patients with slight wounds that heal very slowly or not at all; this condition is due to the union of the syphilitic and psoric influences. In this same category we may place the stitch abscesses which occur following operative measures, in hospitals and under the best of sanitary conditions.
We have spoken a great deal of the tubercular diathesis as being a combination of the syphilitic and psoric stigmata. The scrofulous diathesis is also a combination of these two stigmata, but it differs in the proportionate degree of the presence of the taints, and is further influence by the suppressive measures of crude drugging. Probably environment and circumstances have some bearing on it also. However, the suppression is a strong factor in its individual expression, because this has buried it deeper in the system.
The scrofulous diathesis manifests itself largely by the involvement of the glandular system, particularly the lymphatics. While many authorities have classed scrofula as psoric, its relation may be traced by its manifestations. Psora has no glandular involvement, by syphilis has a particular affinity for glandular tissue. Scrofula has many symptoms in common with psora, but it has the same tendency to ulceration as syphilis; the relationship may be seen also in the purulent discharges and decomposition of the exudations. Scrofula has the same tendency as syphilis to locate in the organs of the special senses, such as the eyes, ears, nose, lips, etc. The pernicious anaemia of the scrofulous patient resembles very closely the syphilitic parent, and shows its kinship to the tubercular diathesis.
