Let us over look for now that this foundation is not compulsory and follow Hahnemann’s mental processes farther. The postulated chronic infection must be such that it first causes local symptoms, after whose (spontaneous or artificially effected) disappearance a great number of variable maladies follow in which no actual healing occurs. (Example: syphilis). According to Hahnemann, so far as Europe is concerned there are only three such chronic infections as causes of not all but most chronic evil, namely (1) syphilis, (2) sycosis or figwart disease, and (3) the psora which has the itch eruption lying at its base. In respect to syphilis Hahnemann gave a significance which is approximately that which we attribute to it at present. By sycosis he understood the general involvement of complicated gonorrhea in which the local symptom is expressed as the figwart. Hahnemann ascribes only a relatively insignificant role to sycosis as a cause of chronic maladies; moreover, it appears only from time to time. In the time of the French war, 1809-1814, it must have been very extensive, and if one follows Hahnemann’s report it seems to have had some extraordinary manifestations (large, elevated, brown, dry nodules in the axilla, on the outer throat, on the scalp, etc. shortening of the tendons of the flexor muscles, particularly of the finger) combined with it.


Hahnemann emphasized the psora as of outstanding importance: The oldest, most universal, most pernicious and still usually mistaken chronic miasmatic disease. At least seven-eighths of all chronic illness he traces back to the psora, and only about one-eighth charges to syphilis and sycosis together.

Hahnemann published his theory of chronic diseases and with it the psora in 1828 in Vol.1 of Chronic Diseases. At that time he was seventy-three years of age. If one reads this discussion through with an open mind, then he notes, in contrast to the tense sequential speech of the Organon, many repetitions which do not serve to explain the theory farther. Although one does not have the impression of a loquacitas senilis, there is the ring of incompletely formulated mental sequences. Only in a type of summary has Hahnemann finished these thoughts and then, capricious as he was, attributed itch as the cause of psora and therewith the majority of chronic diseases. He gave the most unimportant aspect of the entire psora theory an excessive accent and there was and still is the danger that the good is cast away with the bad, that is, in this instance that theoretically and practically important thoughts on the relations of chronic diseases remain unconsidered.

If Hahnemann perceived as the point of departure of psora the infection with itch and the itch eruption as its externally localized symptom, then we cannot follow him. It is naturally to be considered that Hahnemann included much more under the conception of itch than what we know as the effect of Acarus scabiei. He includes all types of itching eruptions as local symptoms. Hahnemann would be quite understandable at present if he had made the tubercle bacillus the cause of the basic malady psora, or better, could have made it. A universally present infectious agent by which every individual is, so to speak, set apart and which revokes important defense manifestations in the skin- that appealed to him as the cause of psora. His mistake does not become less by the fact that he could base his statement on a widely spread viewpoint of the period on the results of the itch, as on Prof. Autenreith, of Tubingen. Moreover, one gains the impression from reading the sixth edition of the Organon that he later avoided calling the itch the sole cause of psora. In 78-83, which treat of the chronic diseases, the itch as is the cause or the skin eruption as the local expression of psora is not expressly mentioned and here one can interchange without further discussion chronic infections with itching skin eruptions with psora. Only in Ap.204 of the sixth edition of the Organon Hahnemann expressly mentions the itch eruption as primary, vicarious and the local symptom preventing the outbreak of internal psora. Moreover, it proceeds particularly from this paragraph that the Hahnemann of 1842 no longer generalized on the psoric origin of chronic diseases as he had in 1828. He also cites prolonged unhygienic modes of life and the damages from the prescriptions of the old school as causes of chronic disease and states that the greatest part of the remaining chronic diseases from the development of the three chronic miasms mentioned: internal syphilis, internal sycosis but particularly and in far greater proportions the internal psora prevails. If in place of psora we place tuberculinization, then Hahnemann is not far removed from our present position. Naturally, under protracted unhygienic life the psychic causes of chronic diseases must be included as Hahnemann stresses sufficiently in other places; and further, in place of drug damages one need simply place chemical intoxications because certainly the industrial agents belong here. Alcoholism can be assigned either to dietary sins or to chemical intoxications. Finally, we would not include chronic gonorrhea in a series of diseases as those chronic illnesses caused by syphilis and tuberculosis, otherwise we would have to include perhaps malaria and dysentery. But it is true that syphilis and tuberculosis among the infections are the most important reorganizers of the individual and contemporary mankind and it is fitting to speak of syphilism and tuberculism.

The theory of Hahnemann is an audacious attempt to trace back all chronic maladies to one or a few infections as causes. The attempt does not succeed. Even the proof for the infectious origin is incomplete. Hahnemann states: because not even the most robust nature and the soundest method of living will not overcome the chronic malady and avert its increase so must the cause lie in a constantly active infection with an independent parasitic existence. The conceptions of the most robust constitution and the soundest mode of living are too general. For example, in an apparently robust constitution single organs may be defective, so that the normal use in the course f life leads to chronic disease (for example, contracted kidney). Here it seems to us that Hahnemann did not sufficiently consider the living reciprocal play between external damages and internal living conditions even though the tracing back to a few infections as the cause of countless numbers of chronic maladies is excellent for that time.

Although Hahnemann takes for a point of departure of psora only the name of itch, in actuality he includes all skin eruptions so that he places the signs of latent and manifest psora extraordinarily wide. Psora becomes for him the mother soil of almost all chronic maladies, which naturally he does not designate with names of disease but with the symptoms observed. In his register we find scrofula, rickets, tuberculosis, asthma, benign and malignant tumors, arthritis, psychosis and many others cited as springing from psora. But the unfortunate attempt at simplification is not the essential but simply the recognition of the reciprocal relation of skin manifestations with so many chronic internal maladies. In the skin manifestations he perceives always the lesser evil and in the recession, either without assistance or even through external treatment, a fatal aggravation of the total process. For this reciprocal relation whose neglect can be so harmful, he cites almost 100 examples from older writers which are added to the conclusions drawn from his own observations. Now a days one comes ever more to a recognition of the outstanding significance of the skin as a defense organ. I refer here merely to Much, Bloch, and Hoffmann and to the conception of esophylaxis. The observations of older writers on the harmful results of forcible suppression of skin eruption, of old ulcus cruris, of hemorrhoids of foot sweats, etc. and the corresponding reports from patients deserve the complete attention of physician even if a compete explanation of this reciprocal relation between the skin eruptions and internal diseases still lies in the remote future. The old physicians as domestic physicians and observers over a long time had much more occasion to determine these connections. But also among us most will concur in the probability of the correctness of such observations in one another example. The secondary exanthem of syphilis today finds a corresponding decision on its clinical course. (Naturally, the chronic results of an acute exanthem as measles are included here.) This aspect of Hahnemann’s doctrine of chronic diseases still remains living in the homoeopathic school and even today in contrast to the custom of most non-homoeopathic physicians the treatment of eczema or ulcus cruris is a radical one. But from the direction of total medicine it may be assumed as probable that in this fundamental, that is, the denial of external treatment and the necessity for internal treatment of such morbid manifestations, that the homoeopathic conception is correct- entirely apart from the characteristic homoeopathic principle of medicinal therapy.

Otto Leeser
Otto Leeser 1888 – 1964 MD, PHd was a German Jewish homeopath who had to leave Germany due to Nazi persecution during World War II, and he escaped to England via Holland.
Leeser, a Consultant Physician at the Stuttgart Homeopathic Hospital and a member of the German Central Society of Homeopathic Physicians, fled Germany in 1933 after being expelled by the German Medical Association. In England Otto Leeser joined the staff of the Royal London Homeopathic Hospital. He returned to Germany in the 1950s to run the Robert Bosch Homeopathic Hospital in Stuttgart, but died shortly after.
Otto Leeser wrote Textbook of Homeopathic Materia Medica, Leesers Lehrbuch der Homöopathie, Actionsand Medicinal use of Snake Venoms, Solanaceae, The Contribution of Homeopathy to the Development of Medicine, Homeopathy and chemotherapy, and many articles submitted to The British Homeopathic Journal,